IJCM_295A: Long term infested rabies – A case report

Abstract

Introduction: Rabies a zoonotic viral infection continues to be major public health problem majorly in parts of Africa and India. Rabies in majority of cases is fatal and the incubation period is between 20 and 90 days. The patient even if he survives had poor functional outcomes. The strategies adopted by the government and health administrators even though in place may not be enough to prevent the disease as we keep getting cases of rabies. Case Report: The case is of a 31-year-old male with a history of dog bite injury 1 year back. However, the patient was asymptomatic for the following year. The patient had no history of treatment and vaccination. Symptoms started a year later with the patient complaining of lower limb stiffness and developing hydrophobia. The patient succumbed after 10 days of treatment at hospital. Discussion: Rabies is virtually 100 percent fatal and without critical care they die within 2 to 3 days of admission. There are rare cases of survival from rabies which are miniscule. People who are vaccinated may develop high concentration of neutralizing antibodies to suppress the disease. Currently there are no antiviral for treatment of rabies and vaccination is the only known preventive method. In the normal circumstances incubation period is within 3 months. But the possibility of late presentations should be kept in mind as evidenced in this case where the patient developed the disease after 1 year. This is a rare occurrence and would not have been suspected if not for the history of dog-bite and confirmatory findings on autopsy.