Rabies encephalitis or post-vaccination encephalitis in a pregnant woman with a surviving premature neonate

• Autores: Tapia-Pérez, Rafael, Barreda-de la Cruz, Miguel, Alvarez-Gamero, Julio C.
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Universidad Nacional Mayor de San Marcos
• Repositorio: Revistas - Universidad Nacional Mayor de San Marcos
• Lenguaje: español
• OAI Identifier: oai:ojs.csi.unmsm:article/20363
• Enlace del recurso: https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/20363
• Nivel de acceso: acceso abierto
• Materia: Virus de la Rabia; Vacunas Antirrábicas; Encefalitis; Embarazo; Recién Nacido; Prematuro; Rabies Virus; Rabies Vaccines; Encephalitis; Pregnancy; Infant; Premature

Human rabies is a serious infection that requires application of rabies serum and vaccine, which can cause post-vaccination acute demyelinating encephalomyelitis (ADEM). We report a 27-year-old pregnant woman who has been bitten by a dog on her right hand. She didn’t receive rabies serum but she received 5 vaccinations. With last vaccination she presents hand numbness, malaise, fever, hydrophobia, altered consciousness. A cesarean section was performed and the patient was induced a therapeutic coma. Nape skin biopsy and inoculation in mice were negative, while seroneutralization in mice and detection of anti-rabies antibodies were positive. In umbilical cord, mouse seroneutralization was positive. Magnetic resonance imaging revealed lesions compatible with ADEM. By some criteria, it could be rabies; however, the chart would be more compatible with ADEM.