Failure of Rabies Postexposure Prophylaxis In Patients Presenting with Unusual Manifestations

We report an atypical case of paralytic rabies presenting with trismus followed by limb weakness, areflexia, ophthalmoparesis, and bilateral ptosis. Atypical presentations and history of rabies postexposure prophylaxis led to delayed diagnosis. Nucleocapsid and glycoprotein genes of rabies viruses from the patient's and biting dog's brains were of identical sequences.