Rabies virus infection in a 21-year-old male presenting with ascending paralysis after a bat scratch.
| Autor: | Daniels SA; Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., King EM; Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Olivier CJ; Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Harding JP; Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada., Fehlner-Gardiner C; National Reference Laboratory for Rabies, Canadian Food Inspection Agency, Ottawa, Ontario, Canada., Nadin-Davis S; National Reference Laboratory for Rabies, Canadian Food Inspection Agency, Ottawa, Ontario, Canada., Murray MC; Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada [J Assoc Med Microbiol Infect Dis Can] 2020 Oct 11; Vol. 5 (3), pp. 201-208. Date of Electronic Publication: 2020 Oct 11 (Print Publication: 2020). |
| DOI: | 10.3138/jammi-2020-0007 |
| Abstrakt: | A 21-year-old, previously healthy male presented to hospital following 1 week of bilateral asymmetric ascending paralysis, odynophagia, and dysphagia. Initial magnetic resonance imaging (MRI) of the spine revealed an abnormal increased T2 signal with predominant dorsal column involvement and sparing of white matter throughout the cervical cord and extending to T5. The initial presumptive diagnosis was an acute infectious, versus inflammatory, myelitis. On reviewing the history, family members recalled a bat scratch on the left hand, sustained months prior, for which the patient did not seek or receive post-exposure prophylaxis (PEP). Rabies virus (RABV) RNA was detected by quantitative reverse transcription polymerase chain reaction (RT-qPCR) in two saliva samples, while nuchal skin biopsy and cerebrospinal fluid (CSF) were negative. Serum was negative for RABV neutralizing antibody. Sequencing and phylogenetic analyses identified the infecting RABV as a variant associated with silver-haired bats. Following risk assessment of exposure, 67 health care workers and several family members were offered PEP. Competing Interests: The authors have nothing to disclose. (Copyright © 2020, Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada).) |
| Databáze: | MEDLINE |
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