[Progressive human viral encephalitis associated to a bat bite]

Human rabies is a rapidly progressive encephalitis that is transmitted by the bites of an infected mammal.

In June 2004, a male patient was admitted to a hospital emergency department after a 5-days history of progressive right arm pain, paresthesias and muscle weakness. He reported contact with a sick bat 5 weeks before admission. He suffered steady neurologic decline with fever, confusion, disorientation, hydrophobia and aerophobia the following day. The patient died two days later.

Postmortem histopathology showed perivascular mononuclear infiltration and extensive neuronolysis. When the fluorescent antibody technique was applied, most residual neurons were infected by the rabies virus. Lyssavirus isolation was achieved in a murine neuroblastoma cell culture. A nested reverse transcription polymerase chain reaction was positive in the patient's cerebrospinal fluid as well as the tissues of the bat Lasionycteris noctivagans.

Clinicians should suspect rabies when unexplained progressive encephalitis is observed.