Survival Following Paralytic Rabies Encephalomyelitis in a Toddler: Challenges in Confirmation of Diagnosis.
Arya James, Sai Vamshi Varanasi, Shikha Jain et al.
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Case in brief
A 2-year-old toddler presented with rapidly progressive quadriparesis following a dog bite. The atypical presentation of paralytic rabies posed significant diagnostic challenges, complicated by recent post-exposure vaccination. Diagnosis was confirmed through rising levels of rabies virus neutralising antibodies in both CSF and serum. The child received comprehensive intensive care and was successfully discharged after six weeks.
Diagnostic / clinical pearl
Clinicians should consider paralytic rabies in cases of rapid quadriparesis, especially with a history of dog exposure, despite atypical presentation and recent vaccination.
Why it matters
This case highlights the potential for survival in paralytic rabies with appropriate intensive care, emphasizing the need for awareness of atypical presentations in diagnosis.