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Case report of rabies-induced persistent mental symptoms
Xiaoqing Wang1, Xiaowen Yu2, Yangtai Guan3
1Department of Neurology, Changhai Hospital, Shanghai Second Military Medical University, Shanghai, China ; Department of Neurology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
Shanghai Archives of Psychiatry
|April 9, 2015
Summary
A rare case of rabies in a 22-year-old male presented with persistent mental disturbances, including disorientation and paranoia, for six years post-dog bite. This rabies infection led to significant daily functioning impairment and brain atrophy.
Area of Science:
- Neurology
- Infectious Diseases
- Psychiatry
Background:
- Rabies is a fatal viral zoonosis with a high mortality rate.
- Neurological symptoms are common, but persistent mental disturbances are rare.
- Early diagnosis and standard post-exposure prophylaxis are crucial.
Observation:
- A 22-year-old male developed disorientation, paranoia, and aggression following a dog attack and non-standard treatment.
- Rabies antibodies were detected in cerebrospinal fluid one month post-infection.
- Magnetic Resonance Imaging (MRI) revealed abnormal signals in the putamen, caudate nucleus, and insula.
Findings:
- The patient experienced persistent mental symptoms for six years, severely impairing daily functioning.
- Despite neurological and psychiatric symptoms, vital signs remained stable without brainstem damage.
- A follow-up MRI six years later indicated brain atrophy.
Implications:
- This case highlights the potential for rabies to cause rare, long-term psychiatric manifestations.
- It underscores the importance of recognizing atypical rabies presentations.
- Further research into the neurobiological mechanisms of rabies-induced mental disturbances is warranted.
