Bites by mammals and rabies

  • The most common of animal bites globally are bites by dogs, cats and human in that order.
  • Malaise
  • Fever
  • Headache
  • Itching and paraesthesia at the site of bite
  • Encephalitis (manifested by dumbness and agitation)
  • Hydrophobia
  • Paralysis
  • Suspected rabies infection in the biting mammal.
  • MRI scan revealing basal ganglial lesions
  1. General management of mammalian bites
  • Wound cleaning with soap or irrigation with a lot of normal saline water.
  • Debridement
  • Anti-tetanus
  • Prophylactic antibiotics (may be considered)
  • Treatment of subsequent infections.   
  • Management of a suspected bite by rabid mammal
  • See bullet (2) above under the “General management of mammalian bites”
  • Post-exposure prophylaxis (PEP) with anti-rabies vaccine in case of the following: a bite from wild or unprovoked or a sick looking domestic animal; the presence of Negri bodies in the brain of the biting animal; severe bites and bites of the head, neck, face, hands or fingers.
  • The dose of rabies PEP is administered as follows:

* Passive immunization by infiltration of the wound with the rabies immunoglobulin at a dose of 20IU/kg then  20IU/kg IM at gluteal region.


* Active immunization in patients not earlier vaccinated:

   **6 inj of 0.1ml intradermal (forearm or upperarm) given after bite, immediately, 3, 7, 14, 30 and 90 days


   1ml IM given after bite, immediately, 3, 7, 14 and 21 days

* Post-exposure prophylaxis (PEP) for a person previously vaccinated against rabies: 1-mL IM injections on days 0 and 3.

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