Faculty Collaboration Database

Survival after treatment of rabies with induction of coma. N Engl J Med 2005 Jun 16;352(24):2508-14

Date

06/17/2005

Pubmed ID

15958806

DOI

10.1056/NEJMoa050382

Scopus ID

2-s2.0-20444444376 (requires institutional sign-in at Scopus site)   516 Citations

Abstract

We report the survival of a 15-year-old girl in whom clinical rabies developed one month after she was bitten by a bat. Treatment included induction of coma while a native immune response matured; rabies vaccine was not administered. The patient was treated with ketamine, midazolam, ribavirin, and amantadine. Probable drug-related toxic effects included hemolysis, pancreatitis, acidosis, and hepatotoxicity. Lumbar puncture after eight days showed an increased level of rabies antibody, and sedation was tapered. Paresis and sensory denervation then resolved. The patient was removed from isolation after 31 days and discharged to her home after 76 days. At nearly five months after her initial hospitalization, she was alert and communicative, but with choreoathetosis, dysarthria, and an unsteady gait.

Author List

Willoughby RE Jr, Tieves KS, Hoffman GM, Ghanayem NS, Amlie-Lefond CM, Schwabe MJ, Chusid MJ, Rupprecht CE

Authors

George M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of Wisconsin
Rodney E. Willoughby MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Amantadine
Anesthetics
Animals
Antiviral Agents
Athetosis
Benzodiazepines
Bites and Stings
Chiroptera
Chorea
Coma
Dysarthria
Female
Gait Disorders, Neurologic
Humans
Ketamine
Midazolam
Rabies
Rabies virus
Ribavirin