title: Failure of rabies postexposure prophylaxis in patients presenting with unusual manifestations.
abstract: We report an atypical case of paralytic rabies presenting with trismus followed by limb weakness, areflexia, ophthalmoparesis, and bilateral ptosis. Atypical presentations and history of rabies postexposure prophylaxis led to delayed diagnosis. Nucleocapsid and glycoprotein genes of rabies viruses from the patient's and biting dog's brains were of identical sequences.
authors.affiliation: Queen Saovabha Memorial Institute, The Thai Red Cross Society (World Health Organization Collaborating Center for Research on Rabies Pathogenesis and Prevention), Bangkok, Thailand. sprapimporn@gmail.com
authors.forename: Prapimporn
authors.initials: P
authors.lastname: Shantavasinkul
authors.forename: Terapong
authors.initials: T
authors.lastname: Tantawichien
authors.forename: Supaporn
authors.initials: S
authors.lastname: Wacharapluesadee
authors.forename: Anuruck
authors.initials: A
authors.lastname: Jeamanukoolkit
authors.forename: Piyada
authors.initials: P
authors.lastname: Udomchaisakul
authors.forename: Pairoj
authors.initials: P
authors.lastname: Chattranukulchai
authors.forename: Patarapha
authors.initials: P
authors.lastname: Wongsaroj
authors.forename: Pakamatz
authors.initials: P
authors.lastname: Khawplod
authors.forename: Henry
authors.initials: H
authors.lastname: Wilde
authors.forename: Thiravat
authors.initials: T
authors.lastname: Hemachudha
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D006801:Humans; D007116:Immunization, Passive / Q000379:methods; D008297:Male; D056990:Post-Exposure Prophylaxis / Q000379:methods*; D011818:Rabies / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control* / Q000821:virology; D011819:Rabies Vaccines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D011819:Rabies Vaccines