CASE REPORT
Rabies Encephalitis Associated with a Remote Dog Bite Exposure More Than a Decade Earlier
Rajeev Ranjan1, Kundan Mishra2, Rishikesh Shaw2, Bhawna Sharma3, Vikas Lakhanpal1*
1- Department of Internal Neurology, All India Institute of Medical Sciences, Bathinda, Punjab, India
2- Department of Internal Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
3- Department of Internal Microbiology, All India Institute of Medical Sciences, Bathinda, Punjab, India
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ABSTRACT
There are rare case reports of rabies encephalitis with an exceptionally prolonged incubation period. Clinical presentation in a man in his early forties includes acute-onset hydrophobia and agitation. The history of a stray dog bite 15 years back, without any post-exposure prophylaxis (PEP), was subsequently elicited. Positive RT-PCR testing of saliva and brain tissue (post-mortem) and histopathological identification of Negri bodies confirmed Rabies. The patient had a remote history of an unvaccinated dog bite of more than a decade before symptom onset, representing the most plausible exposure identified. However, unrecognized subsequent exposures cannot be completely excluded.
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