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.