title: Rabies encephalitis in a child: a failure of rabies post exposure prophylaxis?
abstract: Rabies remains a serious public health problem in many developing countries. The diagnosis is easy when a non-immunised patient presents with hydrophobia and hypersalivation after a bite by a known rabid animal but more difficult when a patient presents atypical symptoms after having received rabies postexposure prophylaxis. Rabies postexposure prophylaxis failure is rare. We report a case of a 6-year-old boy who presented febrile seizure with agitation and cerebellar signs, without hydrophobia or hypersalivation, 17 days after a dog bite. Despite four doses of rabies vaccine and immunoglobulin, he died. Diagnostic confirmation of rabies encephalitis was made in post mortem on brain biopsies by fluorescent antibody technique.
authors.affiliation: Department of Pediatrics B, Children's Hospital Bechir Hamza of Tunis, Tunis, Tunisia.
authors.forename: Faten
authors.initials: F
authors.lastname: Tinsa
authors.affiliation: Pediatric Intensive Care Unit, Children's Hospital Bechir Hamza, Tunis, Tunisia.
authors.forename: Aida
authors.initials: A
authors.lastname: Borgi
authors.affiliation: Department of Pediatrics B, Children's Hospital Bechir Hamza of Tunis, Tunis, Tunisia.
authors.forename: Imen
authors.initials: I
authors.lastname: Jahouat
authors.affiliation: Department of Pediatrics B, Children's Hospital Bechir Hamza of Tunis, Tunis, Tunisia.
authors.forename: Khadija
authors.initials: K
authors.lastname: Boussetta
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D000818:Animals; D000998:Antiviral Agents / Q000008:administration & dosage; D001344:Autopsy; D001733:Bites and Stings; D002648:Child; D004283:Dog Diseases / Q000276:immunology; D004285:Dogs; D017809:Fatal Outcome; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D008297:Male; D056990:Post-Exposure Prophylaxis / Q000379:methods; D011818:Rabies / Q000188:drug therapy* / Q000276:immunology; D011820:Rabies virus / Q000472:pathogenicity*; D013997:Time Factors
chemical_list: D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D000212:Acyclovir