Recovery from rabies, a universally fatal disease

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Rabies is a fatal zoonotic disease transmitted by infected mammals, causing approximately 65,000 deaths annually.
• The disease, known since antiquity, has a near-100% fatality rate in humans if post-exposure prophylaxis is not administered.

Purpose of the Study:

• To report a unique case of human rabies survival.
• To highlight the clinical presentation and diagnostic findings in a non-immunized patient.

Main Methods:

• Case presentation of a 13-year-old boy following a dog bite.
• Diagnostic confirmation through rabies antigen detection in nuchal skin biopsy and corneal smear.
• Magnetic resonance imaging (MRI) revealed extensive brain abnormalities.

Main Results:

• The patient presented with altered sensorium one month post-dog bite without prior rabies immunization.
• Extensive T2W/FLAIR hyperintensities were observed in deep gray matter, hippocampus, brainstem, and cerebellum.
• The patient achieved a slow but significant recovery over four months with supportive therapy.

Conclusions:

• Survival following rabies infection is exceptionally rare, challenging the perception of its universally fatal outcome.
• This case underscores the importance of supportive management and potential for neurological recovery, albeit with sequelae.