Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat
ABSTRACT Rabies encephalitis is a fatal zoonotic viral disease transmitted to humans either by domestic animals like dogs and cats or by wild animals like bats, skunks and raccoons. We present the case of a 25-year-old woman admitted due to behavioral disorders, generalized paresthesiasand acute res...
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ftdoajarticles:oai:doaj.org/article:bbe3ed432f5b423a9a21d9447fba165e 2024-09-09T19:26:18+00:00 Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat Silvia Soler-Rangel Natalie Jiménez-Restrepo Daniel Nariño Diego Rosselli 2020-01-01T00:00:00Z https://doi.org/10.1590/s1678-9946202062001 https://doaj.org/article/bbe3ed432f5b423a9a21d9447fba165e EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652020000100500&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202062001 https://doaj.org/article/bbe3ed432f5b423a9a21d9447fba165e Revista do Instituto de Medicina Tropical de São Paulo, Vol 62 (2020) Rabies Encephalitis Zoonoses Severe acute respiratory syndrome Extra-neural manifestations Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2020 ftdoajarticles https://doi.org/10.1590/s1678-9946202062001 2024-08-05T17:49:30Z ABSTRACT Rabies encephalitis is a fatal zoonotic viral disease transmitted to humans either by domestic animals like dogs and cats or by wild animals like bats, skunks and raccoons. We present the case of a 25-year-old woman admitted due to behavioral disorders, generalized paresthesiasand acute respiratory deterioration compatible with a respiratory distress syndrome (ARDS) requiring orotracheal intubation, mechanical ventilation and empirical initiation of antibiotic and antiviral therapy. Chest tomography showed pneumomediastinum and changes suggestive of pulmonary infection. In the presence of neurological symptoms, a central nervous system (CNS) infection was suspected and the cerebrospinal fluid showed no pleocytosis, hiperproteinorrachy without glucose consumption; cranial CT scan was normal. During hospitalization, the family reported that the patient was bitten by a cat 30-day prior to the onset of rabies-like symptoms, and the animal was sacrificed. The patient had an unfavorable clinical evolution, with electroencephalographic activity dissociation evidenced by video telemetry. The zoonotic exposure led to the suspected diagnosis of rabies infection. The patient died and the suspected diagnosis was confirmed by histopathology, with presence of Negri bodies on cerebellum Purkinje cells and a positive immunofluorescence test for rabies virus. Both, initial extra-neural manifestations and late reporting of rabies exposure led to delayed diagnosis. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista do Instituto de Medicina Tropical de São Paulo 62 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Rabies Encephalitis Zoonoses Severe acute respiratory syndrome Extra-neural manifestations Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Rabies Encephalitis Zoonoses Severe acute respiratory syndrome Extra-neural manifestations Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Silvia Soler-Rangel Natalie Jiménez-Restrepo Daniel Nariño Diego Rosselli Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat |
topic_facet |
Rabies Encephalitis Zoonoses Severe acute respiratory syndrome Extra-neural manifestations Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
ABSTRACT Rabies encephalitis is a fatal zoonotic viral disease transmitted to humans either by domestic animals like dogs and cats or by wild animals like bats, skunks and raccoons. We present the case of a 25-year-old woman admitted due to behavioral disorders, generalized paresthesiasand acute respiratory deterioration compatible with a respiratory distress syndrome (ARDS) requiring orotracheal intubation, mechanical ventilation and empirical initiation of antibiotic and antiviral therapy. Chest tomography showed pneumomediastinum and changes suggestive of pulmonary infection. In the presence of neurological symptoms, a central nervous system (CNS) infection was suspected and the cerebrospinal fluid showed no pleocytosis, hiperproteinorrachy without glucose consumption; cranial CT scan was normal. During hospitalization, the family reported that the patient was bitten by a cat 30-day prior to the onset of rabies-like symptoms, and the animal was sacrificed. The patient had an unfavorable clinical evolution, with electroencephalographic activity dissociation evidenced by video telemetry. The zoonotic exposure led to the suspected diagnosis of rabies infection. The patient died and the suspected diagnosis was confirmed by histopathology, with presence of Negri bodies on cerebellum Purkinje cells and a positive immunofluorescence test for rabies virus. Both, initial extra-neural manifestations and late reporting of rabies exposure led to delayed diagnosis. |
format |
Article in Journal/Newspaper |
author |
Silvia Soler-Rangel Natalie Jiménez-Restrepo Daniel Nariño Diego Rosselli |
author_facet |
Silvia Soler-Rangel Natalie Jiménez-Restrepo Daniel Nariño Diego Rosselli |
author_sort |
Silvia Soler-Rangel |
title |
Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat |
title_short |
Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat |
title_full |
Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat |
title_fullStr |
Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat |
title_full_unstemmed |
Rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat |
title_sort |
rabies encephalitis and extra-neural manifestations in a patient bitten by a domestic cat |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2020 |
url |
https://doi.org/10.1590/s1678-9946202062001 https://doaj.org/article/bbe3ed432f5b423a9a21d9447fba165e |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 62 (2020) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652020000100500&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202062001 https://doaj.org/article/bbe3ed432f5b423a9a21d9447fba165e |
op_doi |
https://doi.org/10.1590/s1678-9946202062001 |
container_title |
Revista do Instituto de Medicina Tropical de São Paulo |
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62 |
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