Failure of rabies postexposure prophylaxis in patients presenting with unusual manifestations.
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.
Shantavasinkul
Prapimporn
P
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
Tantawichien
Terapong
T
Wacharapluesadee
Supaporn
S
Jeamanukoolkit
Anuruck
A
Udomchaisakul
Piyada
P
Chattranukulchai
Pairoj
P
Wongsaroj
Patarapha
P
Khawplod
Pakamatz
P
Wilde
Henry
H
Hemachudha
Thiravat
T
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
D011819:Rabies Vaccines