RABIES ENCEPHALOMYELITIS IN CHILDREN - PARALYTIC FORM. CASE REPORT

G. Jugulete, A. E. Bastian, S. A. Zurac, M. M. Merișescu, M. L. Luminos,

Abstract: Romania is still an endemic country for rabies, and over the past 10 years several cases have been confirmed in both adults and children. Rabies is an acute encephalomyelitis, quite rare in Europe, with an unfavorable evolution in all cases, which is present especially in wooded, mountainous areas on all continents, and bypasses island countries. It is caused by rabies virus, a RNA virus belonging to the Rhabdoviridae Family. The source of infection is sick animals that do not survive for more than a week but can transmit the infection to people via infected saliva, invariably resulting in extremely severe forms of disease, with death. There are two clinical forms of illness - angry and paralytic, preceded by a prodrome. In this article we will present the clinical case of a 9-year-old patient admitted to the pediatric department of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” with the diagnosis of acute rabies encephalo-myelitis. The clinical form of the disease was extremely severe, requiring inducing coma and orotracheal intubation and mechanical ventilation, but the evolution was unfavorable, resulting in death. The interval from the time of the clinical suspicion until the time of death was unusually high, probably due to very good palliative care. The patient did not benefit from post-bite prophylaxis with vaccine or anti-rabies serum.
Keywords: child, severe encephalitis, rabies