Abstract
11Department of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, 2Department ofNeurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, 3Department of Intensive Care, Academic Medical Center, University ofAmsterdam, Amsterdam, The Netherlands, 4Department of Clinical Virology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,5Department of Virology, Erasmus Medical Centre, Rotterdam, The Netherlands, 6Department of Radiology, Academic Medical Center, University of Amsterdam,Amsterdam, The Netherlands, 7Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, 8Centre of Expertise forRabies, Canadian Food Inspection Agency, Ottawa Laboratory (Fallowfield), Ottawa, Ontario, Canada
Highlights
Rabies, encephalitis caused by lyssaviruses, was considered universally fatal until a young, unvaccinated patient with bat rabies survived after a new therapeutic approach [1]
We report on a patient with rabies due to Duvenhage virus from a bat in Kenya
This report was included in the review of Wilde et al [3]. We present this patient in more detail and with results of virological and pathological investigations
Summary
Encephalitis caused by lyssaviruses, was considered universally fatal until a young, unvaccinated patient with bat rabies survived after a new therapeutic approach [1]. On day 2 of admission, her temperature was 38.5uC, the dysarthria had worsened, and she complained of difficulty with swallowing. An MRI showed an area of increased signal intensity on T2-weighted images in the posterior part of the medulla oblongata and pons (Figure 1) The day she was drowsy and there was nuchal rigidity. The treatment protocol used for the rabies patient who survived [1] was started on day 7 of admission, after information was provided to her husband and family and with their consent. On day 11 of admission the presence of Duvenhage virus in the nuchal skin biopsy specimen from the 2nd day of admission was confirmed This may seem like a long delay, but only one of the two agarose gels tested by PCR showed a faint band, and the repeated test in duplicate was negative in both tests. Rabies virus antigen was not detected in other regions of the brain nor in adrenal glands, salivary gland, pancreas, thyroid, heart, or gastrointestinal tract
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