ABSTRACT 629

Abstract

Background and aims: We introduce paralytic rabies with acute axonal neuropathy that closely resembled axonal Guillain-Barre syndrome (GBS). Aims: 14 year old Syrian male patients suffered vomiting, headache and fever which started 3 days ago and quickly spread to the upper extremities with complaints of muscle weakness was noted that refer to external center. He was hospitalized 2 days ago with a preliminary diagnosis of GBS and prophylactic administration of antibiotics and IVIG therapy was started. But muscle weakness was progressed, he was transferred to PICU. Respiratory failure was developed and intubated. EMG showed severe axonal degeneration and demyelination ascending paralysis finding and albuminocytologic dissociation in CSF examination suggested for the GBS as a preliminary diagnosis and plasmapheresis (PF) was started, but clinical improvement wasn’t found. 2 months ago in Syria, he had been bitten by a street dog from left ankle and did not receive prophylaxis. Rabies was suspected and biopsy samples also taken and sent to the National Reference Laboratory, the circulatory collapse occurred and died. Postmortem brain biopsy was taken be in the tissue of Negri inclusion bodies were found, skin biopsy was positive DFA, virus was isolated in the samples. Results: Due to Syrian civil war, the number of immigrants in our country is increasing. Syria’s health services can not be applied because of the war, and one of the results is the increasing number of rabies cases, although it is not an endemic region in our country. Acute onset and rapid deterioration in the differential diagnosis of viral encephalitis, rabies should be considered too.