Examqo › Examqo library › Family medicine › Common complaints and infections · IMLE
Animal bites and rabies
Every bite needs three things addressed: the wound (prolonged irrigation, and sometimes prophylactic antibiotics), tetanus, and rabies — and the decision on rabies prophylaxis rests on the kind of animal and whether it can be observed for 10 days.
Why it matters in the exam
The exam presents a child bitten by a known, vaccinated dog, a child bitten in the face by the family cat, an unvaccinated girl bitten by a dog, and a child bitten by an unidentified snake. It asks whether rabies prophylaxis, antibiotics or tetanus are needed, and how the wound is managed.
Remember that cat bites penetrate deeply and become infected more often than dog bites, and that in Israel a bite from a wild animal (jackal, fox, bat) requires rabies prophylaxis.
In Israel the decision on rabies prophylaxis is made at rabies prevention stations and district health offices, so the family doctor treats the wound and refers there in time. Further questions deal with a human bite, which is treated like a cat bite.
Key points
- Irrigate with water and soap for at least 15 minutes.
- Amoxicillin-clavulanate for a cat bite, hand, face or deep wound.
- A pet dog or cat that is available — 10-day observation.
- A wild or unavailable animal — immunoglobulin and vaccine on days 0, 3, 7, 14.
- Snake bite — immobilise and transfer; no tourniquet.
Summary table
| Topic | When | What is given | Exam note |
|---|---|---|---|
| Wound care | Every bite | Irrigation with water and soap for at least 15 minutes, debridement | Do not close puncture wounds or hand wounds; the face may be closed |
| Prophylactic antibiotics | Cat bite, hand or face, deep wound, oedema, immunosuppression or splenectomy | Amoxicillin-clavulanate for 3–5 days | Pasteurella in cats and dogs |
| Tetanus | According to doses received and wound type | Td and immunoglobulin if needed | A bite is a dirty wound |
| Rabies — a dog or cat that can be observed | The animal is healthy and available for observation | 10-day observation; prophylaxis only if it falls ill or disappears | Decided together with the district health office |
| Rabies — a wild or unknown animal | Jackal, fox, wolf, bat, or a dog that disappeared | Immunoglobulin 20 units/kg around the wound and vaccine on days 0, 3, 7, 14 | In a previously vaccinated person — 2 vaccine doses without immunoglobulin |
| Snake bite (Palestine viper) | Local swelling and pain, systemic symptoms | Immobilise, transfer to hospital, antivenom according to progression | No tourniquet, no incision and no suction |
In the full version for subscribers
- A simple algorithm
- Memory aid
- Exam traps
- 5 review cards
- Enough for IMLE
The full version is open to subscribers of: Family medicine, Medical licensing exam (IMLE), Emergency medicine, Pediatrics, General surgery.
Subscriber? Read the full topic Plans and prices 25 free questions
Sources
- Israel Ministry of Health, current edition — Guidelines for rabies post-exposure prophylaxis (rabies prevention stations)
- Infectious Diseases Society of America, 2014 — Practice guidelines for the diagnosis and management of skin and soft tissue infections — animal bites
- WHO, 2018 — Rabies vaccines: WHO position paper
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.