Format

Send to

Choose Destination
Arch Neurol. 2000 Dec;57(12):1765-9.

Correlation of clinical and neuroimaging findings in a case of rabies encephalitis.

Author information

1
Department of Neurology, Room S262, 513 Parnassus Ave, University of California, San Francisco, CA 94143, USA. samuelp@itsa.ucsf.edu

Abstract

BACKGROUND:

Rabies encephalitis is a feared, virtually uniformly fatal form of central nervous system infection. The incidence of rabies encephalitis in the United States is almost certainly underestimated because of the predominance of bat-borne rabies, which can be spread without traumatic exposure. Because of its rarity in developed countries, rabies encephalitis has been seldom studied with modern imaging techniques.

SETTING:

University-based teaching hospital.

PATIENT:

A case of pathologically confirmed rabies encephalitis is presented. Diagnosis of rabies was made by seroconversion testing while the patient was alive and was confirmed postmortem by the presence of rabies antigens and Negri bodies in the brain. The patient had 2 magnetic resonance studies done that showed dramatic abnormalities in the medulla and pons that correlated with features of the neurologic examination and hypothalamic-pituitary abnormalities.

RESULT:

The patient had a fulminant encephalitic course that ended in death.

CONCLUSION:

Rabies is an uncommon cause of fatal encephalitis. Anatomic imaging studies such as computed tomographic and magnetic resonance scans have generally been negative in confirmed cases of rabies. We report a case of confirmed rabies with extensive brainstem and hypothalamic-pituitary abnormalities on magnetic resonance imaging. Although these findings are nonspecific, they should raise the clinical suspicion of rabies in the setting of aggressive encephalitis of unclear cause, and appropriate diagnostic tests should be performed.

PMID:
11115243
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center