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Diagnostic difficulties in human rabies: A case report and review of the literature

Rabies is a zoonotic disease with the highest fatality rate of any infectious disease. The clinical features of rabies encephalopathy are highly nonspecific at the onset and clinicians from low endemic areas usually face difficulties in recognizing cases during the early stages. The need for establi...

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Autores principales: Chacko, Kadavil, Parakadavathu, Rakesh Theeyancheri, Al-Maslamani, Muna, Nair, Arun P, Chekura, Amrutha Puthalalth, Madhavan, Indira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: HBKU Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427514/
https://www.ncbi.nlm.nih.gov/pubmed/28534007
http://dx.doi.org/10.5339/qmj.2016.15
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author Chacko, Kadavil
Parakadavathu, Rakesh Theeyancheri
Al-Maslamani, Muna
Nair, Arun P
Chekura, Amrutha Puthalalth
Madhavan, Indira
author_facet Chacko, Kadavil
Parakadavathu, Rakesh Theeyancheri
Al-Maslamani, Muna
Nair, Arun P
Chekura, Amrutha Puthalalth
Madhavan, Indira
author_sort Chacko, Kadavil
collection PubMed
description Rabies is a zoonotic disease with the highest fatality rate of any infectious disease. The clinical features of rabies encephalopathy are highly nonspecific at the onset and clinicians from low endemic areas usually face difficulties in recognizing cases during the early stages. The need for establishing a rapid and accurate test to identify rabies during the ante-mortem period is important. However, in actual clinical practice, the latter may remain difficult for various reasons. In human rabies, positively identifying the antigen, antibody or genetic material by various diagnostic methods during the symptomatic period is affected by the unpredictable nature of viremia, levels of antibody immune response of the host, and the virulence of the infecting strain. Also, more advanced testing with greater sensitivity may not be readily available at all centers. Here we describe a case of a young male who was bitten by a rabid dog and developed progressive encephalopathy with a fatal outcome, with negative antibodies in the cerebrospinal fluid (CSF). A review of the literature on the clinical features, diagnostic tests, treatment and prevention of rabies is also presented.
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spelling pubmed-54275142017-05-22 Diagnostic difficulties in human rabies: A case report and review of the literature Chacko, Kadavil Parakadavathu, Rakesh Theeyancheri Al-Maslamani, Muna Nair, Arun P Chekura, Amrutha Puthalalth Madhavan, Indira Qatar Med J Case Report Rabies is a zoonotic disease with the highest fatality rate of any infectious disease. The clinical features of rabies encephalopathy are highly nonspecific at the onset and clinicians from low endemic areas usually face difficulties in recognizing cases during the early stages. The need for establishing a rapid and accurate test to identify rabies during the ante-mortem period is important. However, in actual clinical practice, the latter may remain difficult for various reasons. In human rabies, positively identifying the antigen, antibody or genetic material by various diagnostic methods during the symptomatic period is affected by the unpredictable nature of viremia, levels of antibody immune response of the host, and the virulence of the infecting strain. Also, more advanced testing with greater sensitivity may not be readily available at all centers. Here we describe a case of a young male who was bitten by a rabid dog and developed progressive encephalopathy with a fatal outcome, with negative antibodies in the cerebrospinal fluid (CSF). A review of the literature on the clinical features, diagnostic tests, treatment and prevention of rabies is also presented. HBKU Press 2017-04-21 /pmc/articles/PMC5427514/ /pubmed/28534007 http://dx.doi.org/10.5339/qmj.2016.15 Text en © 2016 Chacko, Parakadavathu, Al-Maslamani, Nair, Chekura, Madhavan, licensee HBKU Press. This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Chacko, Kadavil
Parakadavathu, Rakesh Theeyancheri
Al-Maslamani, Muna
Nair, Arun P
Chekura, Amrutha Puthalalth
Madhavan, Indira
Diagnostic difficulties in human rabies: A case report and review of the literature
title Diagnostic difficulties in human rabies: A case report and review of the literature
title_full Diagnostic difficulties in human rabies: A case report and review of the literature
title_fullStr Diagnostic difficulties in human rabies: A case report and review of the literature
title_full_unstemmed Diagnostic difficulties in human rabies: A case report and review of the literature
title_short Diagnostic difficulties in human rabies: A case report and review of the literature
title_sort diagnostic difficulties in human rabies: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427514/
https://www.ncbi.nlm.nih.gov/pubmed/28534007
http://dx.doi.org/10.5339/qmj.2016.15
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