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Human rabies.

J Libby, H W Meislin

    Annals of Emergency Medicine
    |April 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

    This case report details a rare instance of rabies in a 40-year-old man, highlighting the diagnostic challenges and aggressive treatment required for this fatal viral infection.

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    Area of Science:

    • Neurology
    • Infectious Diseases
    • Public Health

    Background:

    • Rabies is a rare but almost universally fatal viral zoonotic disease.
    • Early diagnosis and prompt treatment are critical for patient survival.
    • The disease presents with a range of neurological and non-specific symptoms, complicating early identification.

    Observation:

    • A 40-year-old man with potential rabies exposure developed progressive neurological symptoms including dysphagia, hydrophobia, insomnia, anorexia, malaise, fever, and sensorimotor deficits.
    • Initial diagnosis was challenging due to patient denial and healthcare provider reluctance to consider this rare condition.
    • Despite comprehensive supportive care and antiviral treatment, the patient's condition rapidly deteriorated.

    Findings:

    • Laboratory confirmation of rabies virus infection was established by the Center for Disease Control and Prevention.

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  • The patient received aggressive medical management, including mechanical ventilation, anticonvulsants, steroids, vasopressors, hemodialysis, and interferon therapy.
  • The patient unfortunately died on the 16th day of hospitalization.

    • Implications:

    • This case emphasizes the importance of considering rabies in the differential diagnosis of acute neurological syndromes, particularly in endemic areas or with relevant exposure history.
    • It highlights the critical need for heightened awareness and rapid diagnostic capabilities for rabies in emergency departments.
    • The case also underscores the limitations of current therapeutic interventions for established rabies infection, reinforcing the importance of prevention through vaccination and post-exposure prophylaxis.