Case Report
Year : 2021 | Volume : 5 | Issue : 1 | Page : 17 - 20
An unusual case of fatal rabies encephalitis despite completing postexposure prophylaxis
Hemant Kumar Sharma
Department of Pathology, 158 Base Hospital Bagdogra, Darjeeling, West Bengal, India
Address for correspondence:
Dr. Hemant Kumar Sharma, Department of Pathology, 158 Base Hospital Bagdogra, Darjeeling ‐ 734 424, West Bengal, India.
E‐mail: hemant1303@gmail.com
Abstract
Rabies continues to be a major health scourge in many developing countries including India. It can be effectively prevented by providing postexposure prophylactic treatment. Failure of Rabies postexposure prophylaxis (PEP) is a rare occurrence. Our patient, a 39-year-old Male, was bitten by stray dog on the left hand. It was Category III dog bite for which proper wound care and PEP 5 doses of antirabies cell culture vaccine and Human Rabies Immunoglobulin was given. Two days after completing the 5th dose of PEP, he presented with fever, neck rigidity, drooling of saliva, pain, and numbness in the left hand along with auditory and visual hallucinations without hydrophobia and aerophobia. On 2nd say of hospitalization, he developed progressive respiratory difficulty and decreased oxygen saturation for which he was intubated and put on invasive ventilator support. However, he suffered fatal cardiac arrest and succumbed to his illness. Based on his symptoms, a clinical diagnosis of febrile encephalopathy with differential diagnosis of acute rabies encephalitis was made. On autopsy, his brain was markedly congested and histopathological examination was suggestive of acute rabies encephalitis. However, no Negri bodies were seen. Further examination of brain tissue by immunohistochemical labeling revealed numerous Negri bodies and confirmed the diagnosis of rabies encephalitis.
Keywords: Encephalitis, failures of postexposure prophylaxis, postexposure prophylaxis, rabies postexposure prophylaxis, rabies
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
How to cite this article:
Sharma HK. An unusual case of fatal rabies encephalitis despite completing postexposure prophylaxis. Int J Clinicopathol Correl 2021;5:17-20.
