Rabies Encephalitis on FDG PET CT: First Case of Metabolic Imaging in Rare Survivor

Rabies is almost universally fatal, with survival being extremely rare. An 8-year-old girl sustained a category III dog bite and received incomplete postexposure prophylaxis without immunoglobulin. Two months later, she developed hydrophobia, aerophobia, seizures, and altered sensorium, with clinical and MRI findings consistent with rabies encephalitis. She was discharged against medical advice and received alternative treatment with physiotherapy for nearly 1.5 years. Presenting with increasing seizure frequency, she underwent PET-CT whole body and brain, which showed cerebral and cerebellar atrophy with encephalitic changes. To our best knowledge, this is the first case of PET-CT findings in rabies encephalitis.