Journal
JOURNAL OF MEDICAL VIROLOGY
Volume 82, Issue 7, Pages 1255-1265Publisher
WILEY
DOI: 10.1002/jmv.21785
Keywords
rabies; Milwaukee protocol; therapeutic coma; human case; virus
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Funding
- Department for Environment, Food and Rural Affairs (Defra) [SV3500]
- MRC [G116/194] Funding Source: UKRI
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A 37-year-old woman was admitted to hospital and over the next 5 days developed a progressive encephalitis. Nuchal skin biopsy, analyzed using a Rabies TaqMan(C) PCR, demonstrated rabies virus RNA. She had a history in keeping with exposure to rabies whilst in South Africa, but had not received pre- or post-exposure prophylaxis. She was treated with a therapeutic coma according to the Milwaukee protocol, which failed to prevent the death of the patient. Rabies virus was isolated from CSF and saliva, and rabies antibody was demonstrated in serum (from day 11 onwards) and cerebrospinal fluid (day 13 onwards). She died on day-35 of hospitalization. Autopsy specimens demonstrated the presence of rabies antigen, viral RNA, and viable rabies virus in the central nervous system. J. Med. Virol. 82:1255-1265,2010. (C) 2010 Wiley-Liss, Inc.
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