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Previous Volume 352:2508-2514 June 16, 2005 Number 24 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Video Editorial by Jackson, A. C. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

SUMMARY

We report the survival of a 15-year-old girl in whom clinical rabies developed one month after she was bitten by a bat. Treatment included induction of coma while a native immune response matured; rabies vaccine was not administered. The patient was treated with ketamine, midazolam, ribavirin, and amantadine. Probable drug-related toxic effects included hemolysis, pancreatitis, acidosis, and hepatotoxicity. Lumbar puncture after eight days showed an increased level of rabies antibody, and sedation was tapered. Paresis and sensory denervation then resolved. The patient was removed from isolation after 31 days and discharged to her home after 76 days. At nearly five months after her initial hospitalization, she was alert and communicative, but with choreoathetosis, dysarthria, and an unsteady gait.

Source Information

From the Departments of Pediatric Infectious Diseases (R.E.W., M.J.C.), Pediatric Critical Care Medicine (K.S.T., N.S.G.), Pediatric Anesthesiology (G.M.H.), and Pediatric Neurology (C.M.A.-L., M.J.S.), Medical College of Wisconsin, Milwaukee; and the Centers for Disease Control and Prevention, Atlanta (C.E.R.).

A related video is available at www.nejm.org

Address reprint requests to Dr. Willoughby at the Department of Pediatric Infectious Diseases, 8701 Watertown Plank Rd., Midwest Athletes against Childhood Cancer Fund Research Center, Suite 3019, Milwaukee, WI 53226, or at rewillou{at}mail.mcw.edu.

Full Text of this Article

Related Letters:

Survival after Treatment of Rabies
Hemachudha T., Wilde H., Willoughby R. E. Jr., Rupprecht C. E.
Extract | Full Text | PDF  
N Engl J Med 2005; 353:1068-1069, Sep 8, 2005. Correspondence

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