Minor Facial Injury from Domestic Puppy with Post-Exposure Prophylaxis Administration

Case at a Glance

A 25-year-old female presented with anxiety following a minor facial scratch from a 3-4 month old domestic puppy, seeking reassurance after receiving post-exposure prophylaxis for rabies prevention.

Patient's Story

The patient, a 25-year-old female weighing 46kg, sustained a small scratch on her nose while playing with a young indoor puppy. The injury occurred during close contact play and resulted in minimal bleeding. The puppy had received routine 4-in-1 vaccinations but had not yet received rabies vaccination due to age. Within one hour of the incident, the patient sought medical attention and received both rabies post-exposure prophylaxis and tetanus vaccination. Despite appropriate medical intervention, the patient experienced significant anxiety about potential rabies transmission.

Initial Assessment

Physical examination revealed a minor superficial scratch on the nasal area with minimal bleeding that had already stopped. The patient appeared anxious and requested reassurance about rabies risk. Medical history was unremarkable except for reported health anxiety. The patient was alert, oriented, and showed no signs of infection at the wound site.

The Diagnostic Journey

Given the low-risk nature of the exposure (domestic indoor puppy, playful behavior, minor wound), the rabies risk was assessed as minimal. However, following local animal bite center protocols in the Philippines, post-exposure prophylaxis was initiated as a precautionary measure. The patient's anxiety levels were noted to be disproportionate to the actual medical risk, suggesting underlying health anxiety disorder.

Final Diagnosis

1. Minor facial laceration from domestic animal contact
2. Health anxiety disorder with specific focus on infectious disease transmission
3. Post-exposure prophylaxis administration (appropriate precautionary measure)

Treatment Plan

1. Completed rabies post-exposure prophylaxis series as per protocol
2. Tetanus vaccination updated
3. Wound care education provided
4. Psychological support and reassurance regarding actual risk levels
5. Referral consideration for anxiety management and coping strategies
6. Patient education about rabies transmission patterns and risk factors

Outcome and Follow-up

The patient completed the vaccination series without complications. Wound healing progressed normally without signs of infection. Anxiety levels gradually decreased with appropriate education and support. The patient was advised to seek professional help for health anxiety management to prevent similar episodes in the future. Follow-up confirmed complete recovery with no adverse effects from either the injury or vaccinations.