Rabies encephalitis or post-vaccination encephalitis in a pregnant woman with a surviving premature neonate

Authors

  • Rafael Tapia-Pérez Unidad de Cuidados Intensivos, Hospital Nacional Carlos Alberto Seguín Escobedo, EsSalud. Arequipa, Perú; Facultad de Medicina Humana, Universidad Católica Santa María. Arequipa, Perú. https://orcid.org/0000-0001-6120-1760
  • Miguel Barreda-de la Cruz Unidad de Cuidados Intensivos, Hospital Nacional Carlos Alberto Seguín Escobedo, EsSalud. Arequipa, Perú. https://orcid.org/0000-0003-3268-7786
  • Julio C. Alvarez-Gamero Hospital Nacional Edgardo Rebagliati Martins, EsSalud. Lima, Perú.

DOI:

https://doi.org/10.15381/anales.v82i4.20363

Keywords:

Rabies Virus, Rabies Vaccines, Encephalitis, Pregnancy, Infant, Premature

Abstract

Human rabies is a serious infection that requires application of rabies serum and vaccine, which can cause post-vaccination acute demyelinating encephalomyelitis (ADEM). We report a 27-year-old pregnant woman who has been bitten by a dog on her right hand. She didn’t receive rabies serum but she received 5 vaccinations. With last vaccination she presents hand numbness, malaise, fever, hydrophobia, altered consciousness. A cesarean section was performed and the patient was induced a therapeutic coma. Nape skin biopsy and inoculation in mice were negative, while seroneutralization in mice and detection of anti-rabies antibodies were positive. In umbilical cord, mouse seroneutralization was positive. Magnetic resonance imaging revealed lesions compatible with ADEM. By some criteria, it could be rabies; however, the chart would be more compatible with ADEM.

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Published

2022-01-11

Issue

Section

Reporte de Casos

How to Cite

1.
Tapia-Pérez R, Barreda-de la Cruz M, Alvarez-Gamero JC. Rabies encephalitis or post-vaccination encephalitis in a pregnant woman with a surviving premature neonate. An Fac med [Internet]. 2022 Jan. 11 [cited 2024 Jul. 17];82(4). Available from: https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/20363