• Logo
  • SBMUJournals

Acute and critical care for rabies bitten patients and the different outcomes in a Family: A Post Exposure Prophylaxis (PEP) Failure report

Sara Nouri Basirat, Rouzbeh Bashar, Behzad Pourhossein, Nasim Niknam, Mojtaba Sanji Rafsanjani, Mohammad Reza Shirzadi, Farzaneh Sheikholeslami, Reza Farzad, Maryam Fazeli
7

Views

PDF

Abstract

Rabies is a zoonotic viral disease that spread via infected animal saliva. Rabies virus belongs to Lyssavirus genus (Rhabdoviridae family) and the disease is endemic in Iran. The disease causes a fatal encephalomyelitis by infecting the nervous system. Dogs are the most common source of human rabies cases. In this presentation, we had a 58-year-old man who had a dog bitten history on his face and hands with his other two family members with the same dog at the same time. They received post-exposure prophylaxis (PEP) as soon as possible (from day 0). Eighteen days after bitten the man hospitalized and died of rabies three days after hospitalization. Other two relatives were healthy without any rabies symptom. The man was an Iranian veteran with residual body insults during the attacks of chemical warfare from the combat front. Obtained data in this study suggested that the direct inoculation of the virus to the nerve and immune system inability in virus clearing system were possible etiologies of PEP failure in the reported case.
Keywords: Rabies Virus, Immunoglobulin, Pre-Exposure Prophylaxis (PrEP), Immunosuppression


References

Warrell MJ, Warrell DA. Rabies and other lyssavirus diseases. Lancet. 2004;363(9413):959-69.

Hemachudha T, Laothamatas J, Rupprecht CE. Human rabies: a disease of complex neuropathogenetic mechanisms and diagnostic challenges. Lancet Neurology. 2002;1(2):101-9.

Organization WH. WHO expert consultation on rabies: third report: World Health Organization; 2018.

Shantavasinkul P, Wilde H. Postexposure prophylaxis for rabies in resource-limited/poor countries. Adv Virus Res. 2011;79:291-307.

Bourhy H, Rollin PE, Vincent J, Sureau P. Comparative field evaluation of the fluorescent-antibody test, virus isolation from tissue culture, and enzyme immunodiagnosis for rapid laboratory diagnosis of rabies. J Clin Microbiol. 1989;27(3):519-23.

Fisher CR, Streicker DG, Schnell MJ. The spread and evolution of rabies virus: conquering new frontiers: Nat Rev Microbiol. 2018;16(4):241-255.

Koyuncu OO, Hogue IB, Enquist LW. Virus infections in the nervous system. Cell Host Microbe. 2013;13(4):379-93.

Cleaveland S, Hampson K. Rabies elimination research: juxtaposing optimism, pragmatism and realism. Proc Biol Sci. 2017;284(1869). pii: 20171880.

Razavi SM, Ghanei M, Salamati P, Safiabadi M. Long-term effects of mustard gas on respiratory system of Iranian veterans after Iraq-Iran war: a review. Chin J Traumatol. 2013;16(3):163-8.

Flume PA, Mogayzel PJ Jr, Robinson KA, Goss CH, Rosenblatt RL, Kuhn RJ, Marshall BC; Clinical Practice Guidelines for Pulmonary Therapies Committee. Cystic fibrosis pulmonary guidelines: treatment of pulmonary exacerbations. Am J Respir Crit Care Med. 2009;180(9):802-8.

Ghotbi L, Hassan Z. The immunostatus of natural killer cells in people exposed to sulfur mustard. Int Immunopharmacol. 2002;2(7):981-5.

Enright JB, Goggin JE, Frye FL, Franti CE, Behymer DE. Effects of corticosteroids on rabies virus infections in various animal species. J Am Vet Med Assoc. 1970;156(6):765-9.

Satyanarayanasetty D, Pawar K, Nadig P, Haran A. Multiple Adverse Effects of Systemic Corticosteroids: A Case Report. J Clin Diagn Res. 2015;9(5):FD01-2.




DOI: https://doi.org/10.22037/jcma.v4i4.29172

Refbacks

  • There are currently no refbacks.