A Child Surviving Rabies in Tunisia: A Case Report

Excerpt

To the Editor: A 6-y-old girl presented with high fever, headache, ataxia, and behavioral disorders. The child had been bitten by a stray dog on the left side of her face two weeks earlier. She received four doses of antirabies vaccine and rabies immunoglobulin. No classical signs of rabies-like hydrophobia, aerophobia, or agitation were observed. Both rabies encephalitis and vaccine-induced acute disseminated encephalomyelitis (ADEM) were taken into consideration as potential diagnoses. MRI of the brain and spine showed hyperintensities in T2 and FLAIR images involving the dorsal brain stem, thalamus, and the cervical-dorsal marrow. The CSF PCR for rabies was negative. The CSF rapid fluorescent focus inhibition test (RFFIT) for rabies antibodies showed rabies virus-neutralizing antibody titer of 1:30 UI/ml. …