In:
Official Journal of the Association of Medical Microbiology and Infectious Disease Canada, University of Toronto Press Inc. (UTPress), Vol. 5, No. 3 ( 2020-10-11), p. 201-208
Abstract:
A 21-year-old, previously healthy male presented to hospital following 1 week of bilateral asymmetric ascending paralysis, odynophagia, and dysphagia. Initial magnetic resonance imaging (MRI) of the spine revealed an abnormal increased T2 signal with predominant dorsal column involvement and sparing of white matter throughout the cervical cord and extending to T5. The initial presumptive diagnosis was an acute infectious, versus inflammatory, myelitis. On reviewing the history, family members recalled a bat scratch on the left hand, sustained months prior, for which the patient did not seek or receive post-exposure prophylaxis (PEP). Rabies virus (RABV) RNA was detected by quantitative reverse transcription polymerase chain reaction (RT-qPCR) in two saliva samples, while nuchal skin biopsy and cerebrospinal fluid (CSF) were negative. Serum was negative for RABV neutralizing antibody. Sequencing and phylogenetic analyses identified the infecting RABV as a variant associated with silver-haired bats. Following risk assessment of exposure, 67 health care workers and several family members were offered PEP.
Type of Medium:
Online Resource
ISSN:
2371-0888
DOI:
10.3138/jammi-2020-0007
Language:
English
Publisher:
University of Toronto Press Inc. (UTPress)
Publication Date:
2020
detail.hit.zdb_id:
3041436-2
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