Health Anxiety Following Minor Animal Bite Incident
Case at a Glance
A 23-year-old male presents with persistent health anxiety and somatic symptoms following minor bite wounds from a recently adopted, vaccinated puppy. Despite medical reassurance and completion of observation period, patient continues to experience anxiety-related physical symptoms.
Patient's Story
The patient adopted a 3-month-old puppy 17 days prior to presentation. The puppy, which had been previously vaccinated and health-checked, inflicted minor bite wounds to the patient's nose and feet that produced minimal bleeding. Despite the superficial nature of the wounds and the puppy's vaccinated status, the patient developed intense fear of contracting rabies. He sought medical attention twice within the initial period, receiving reassurance from healthcare providers about the extremely low risk given the geographic location (urban area with no wild animal populations and active stray dog vaccination programs). The patient was advised to observe the puppy for 10 days as a precautionary measure. The puppy remained healthy and continued to grow normally throughout the 17-day observation period.
Initial Assessment
Physical examination revealed superficial, non-infected bite wounds on nose and feet. Patient appeared anxious and reported multiple somatic complaints including insomnia, muscle twitching in extremities and shoulders, fatigue, and morning palpitations. Current medications include fluoxetine and B-complex vitamins, suggesting pre-existing anxiety management.
The Diagnostic Journey
Two separate medical evaluations confirmed minimal infection risk and appropriate wound healing. Healthcare providers assessed the incident as low-risk based on: (1) vaccinated domestic animal source, (2) superficial wound depth, (3) geographic location with controlled animal populations, and (4) active local vaccination campaigns. The 10-day observation period was completed successfully with the animal remaining asymptomatic.
Final Diagnosis
Health anxiety disorder with somatic manifestations secondary to perceived rabies exposure risk. No evidence of actual infection or medical complications from bite wounds.
Treatment Plan
Continue current fluoxetine therapy for underlying anxiety disorder. Patient education regarding completed observation period and actual vs. perceived risk. Cognitive behavioral therapy techniques for health anxiety management. Recommend avoiding additional medical consultations that may reinforce anxiety patterns unless new symptoms develop.
Outcome and Follow-up
Patient continues to experience anxiety despite objective evidence of safety (healthy animal after 17 days, well beyond the standard 10-day observation period). Symptoms are consistent with anxiety-related somatic manifestations rather than infectious disease. Long-term management focuses on anxiety disorder treatment rather than infectious disease concerns.