Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat
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Fecha
2020-01-17Autor(es) Corporativo(s)
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Neurociencias. Neurología
Tipo
Artículo de revista
ISSN
0036-4665 / 1678-9946 (Electrónico)
Páginas
1-5
Tipo de artículo
Reporte de caso
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Abstract
Rabies encephalitis is a fatal zoonotic viral disease transmitted to humans either by
domestic animals like dogs and cats or by wild animals like bats, skunks and raccoons. We
present the case of a 25-year-old woman admitted due to behavioral disorders, generalized
paresthesiasand acute respiratory deterioration compatible with a respiratory distress syndrome
(ARDS) requiring orotracheal intubation, mechanical ventilation and empirical initiation of
antibiotic and antiviral therapy. Chest tomography showed pneumomediastinum and changes
suggestive of pulmonary infection. In the presence of neurological symptoms, a central nervous
system (CNS) infection was suspected and the cerebrospinal fluid showed no pleocytosis,
hiperproteinorrachy without glucose consumption; cranial CT scan was normal. During
hospitalization, the family reported that the patient was bitten by a cat 30-day prior to the onset
of rabies-like symptoms, and the animal was sacrificed. The patient had an unfavorable clinical
evolution, with electroencephalographic activity dissociation evidenced by video telemetry.
The zoonotic exposure led to the suspected diagnosis of rabies infection. The patient died and
the suspected diagnosis was confirmed by histopathology, with presence of Negri bodies on
cerebellum Purkinje cells and a positive immunofluorescence test for rabies virus. Both, initial
extra-neural manifestations and late reporting of rabies exposure led to delayed diagnosis.
Enlace al recurso
https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652020000100500&tlng=enFuente
Revista do Instituto de Medicina Tropical de Sao Paulo; Vol. 62 (2020)
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