Survival of atypical rabies encephalitis

Abstract

Rabies is a fatal zoonotic disease transmitted primarily by dogs, cats, and bats, which accounts for approximately 59,000 deaths globally per year. An 8-year-old boy from rural central India developed an atypical presentation of rabies following a street dog bite in spite of receiving postexposure prophylaxis and proper care of Category III wounds. A diagnosis of rabies was made on the basis of clinical background, neuroimaging finding, excess antibody titer, detection of rabies viral antigen in serum, and exclusion of other etiologies. He had slow but significant recovery with intensive critical care support. The poor outcome in the described case highlights the lack of awareness, especially in rural population, and the importance of timely, adequate, and appropriate postexposure prophylaxis, which remains the only effective intervention for human rabies.