Global Pediatric Health (Dec 2018)

A Case of Serious Adverse Reaction Following Rabies Vaccination

  • Zhilin Kang MBBS, MRCPCH, MMED (Paediatrics),
  • Wen Chin Chiang BMedSci, MBBS, MRCPCH, FAMS,
  • Si Hui Goh MBBS, MRCPCH, MMED (Paediatrics),
  • Anne Eng Neo Goh MBBS, MMED (Paediatrics), FRCPCH, FAMS,
  • Peter Choong Yi Wong MBBS, MRCPCH,
  • Koh Cheng Thoon MBBS, MRCPCH, MMED (Paediatrics),
  • Natalie Woon Hui Tan MBBS, MRCPCH

DOI
https://doi.org/10.1177/2333794X18817143
Journal volume & issue
Vol. 5

Abstract

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Introduction . Rabies is one of the most deadly infectious disease. We present a challenging case of an adverse reaction following rabies vaccine in a child. Case Summary . A 10-year-old girl was bitten by a stray dog in Bali and was prescribed rabies post-exposure prophylaxis. She developed breathlessness, abdominal cramps, and lips and eyes swelling 30 minutes after the second dose of rabies vaccine. The subsequent vaccine was successfully administered as a graded challenge with premedication. The final dose was administered in entirety under close observation. She developed transient hypotension 30 minutes later, which spontaneously resolved. Conclusion . There were multiple challenges in the care of this pediatric patient who was potentially exposed to rabies and experienced systemic adverse events during the course of post-exposure prophylaxis. A thorough clinical assessment should be made to weigh benefits versus risks of proceeding with rabies vaccination, bearing in mind that the disease is deadly.