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Rabies encephalitis.

Ambeshprasad Mohite1, Vinitha Prasad, L Rajam

  • 1Department of Pediatrics, Amrita Institute of Medical Sciences and Research Center, Kochi, Kerala, India.

Indian Pediatrics
|October 9, 2007
PubMed
Summary
This summary is machine-generated.

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A 12-year-old boy developed severe neurological symptoms after a dog bite and rabies vaccination. Despite absent typical rabies signs, MRI confirmed rabies encephalitis, not vaccine-induced ADEM.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Rabies is a fatal viral zoonotic disease preventable by vaccination and immunoglobulin administration.
  • Post-exposure prophylaxis (PEP) is crucial after potential rabies exposure.
  • Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated condition affecting the central nervous system.

Observation:

  • A 12-year-old boy presented with fever, sore throat, vomiting, and altered sensorium 4 weeks after a dog bite and receiving 4 doses of antirabies vaccine.
  • The patient notably lacked typical rabies symptoms such as hydrophobia and aerophobia.
  • Initial differential diagnoses included rabies encephalitis and vaccine-induced ADEM.

Findings:

  • Magnetic Resonance Imaging (MRI) of the brain revealed characteristic grey matter changes, strongly suggesting rabies encephalitis.

Related Experiment Videos

  • Serological tests confirmed the diagnosis of rabies.
  • The clinical presentation and MRI findings favored rabies encephalitis over ADEM.

    • Implications:

    • This case highlights the importance of considering rabies encephalitis even in the absence of classic hydrophobia and aerophobia, especially after potential exposure.
    • It underscores the diagnostic value of neuroimaging (MRI) in differentiating neurological disorders.
    • The findings emphasize the critical need for timely and complete rabies post-exposure prophylaxis, including rabies immunoglobulin when indicated.