Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat.

We present the case of a 25-year-old woman admitted due to behavioral disorders, generalized paresthesiasand acute respiratory deterioration compatible with a respiratory distress syndrome (ARDS) requiring orotracheal intubation, mechanical ventilation and empirical initiation of antibiotic and antiviral therapy. Chest tomography showed pneumomediastinum and changes suggestive of pulmonary infection. In the presence of neurological symptoms, a central nervous system (CNS) infection was suspected and the cerebrospinal fluid showed no pleocytosis, hiperproteinorrachy without glucose consumption; cranial CT scan was normal. During hospitalization, the family reported that the patient was bitten by a cat 30-day prior to the onset of rabies-like symptoms, and the animal was sacrificed. The patient had an unfavorable clinical evolution, with electroencephalographic activity dissociation evidenced by video telemetry. The zoonotic exposure led to the suspected diagnosis of rabies infection. The patient died and the suspected diagnosis was confirmed by histopathology, with presence of Negri bodies on cerebellum Purkinje cells and a positive immunofluorescence test for rabies virus. Both, initial extra-neural manifestations and late reporting of rabies exposure led to delayed diagnosis. PMID: 31967209 [PubMed - in process]
Source: Revista do Instituto de Medicina Tropical de Sao Paulo - Category: Tropical Medicine Authors: Tags: Rev Inst Med Trop Sao Paulo Source Type: research

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Source: Comparative Immunology, Microbiology and Infectious Diseases - Category: Infectious Diseases Source Type: research
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Source: Comparative Immunology, Microbiology and Infectious Diseases - Category: Infectious Diseases Source Type: research
Chandrakant M Bokade, Vishal S Gajimwar, Rajkumar M Meshram, Swapnil B WathoreAnnals of Indian Academy of Neurology 2019 22(3):319-321 Rabies is a fatal zoonotic disease transmitted primarily by dogs, cats, and bats, which accounts for approximately 59,000 deaths globally per year. An 8-year-old boy from rural central India developed an atypical presentation of rabies following a street dog bite in spite of receiving postexposure prophylaxis and proper care of Category III wounds. A diagnosis of rabies was made on the basis of clinical background, neuroimaging finding, excess antibody titer, detection of rabies viral anti...
Source: Annals of Indian Academy of Neurology - Category: Neurology Authors: Source Type: research
We report the clinical and radiological findings of eight patients with laboratory-confirmed rabies who survived the illness. With the exception of one patient who recovered with mild sequelae, all survivors had poor functional outcomes. The reported survival from rabies in recent years may reflect an increased awareness of the disease and greater access to better critical care facilities in rabies-endemic countries. Nonetheless, there is an urgent need to focus on preventive strategies to reduce the burden of this dreadful disease in rabies-endemic countries. PMID: 30398147 [PubMed - as supplied by publisher]
Source: The American Journal of Tropical Medicine and Hygiene - Category: Tropical Medicine Authors: Tags: Am J Trop Med Hyg Source Type: research
CONCLUSION: The results of this study suggest that SYBR Green real-time PCR technique on saliva sample can be used as an applicable method for ante-mortem diagnosis of rabies to avoid infection of other people such as the treating medical staff or family members of the patient. PMID: 30415556 [PubMed - in process]
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Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research
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