TY - JOUR
T1 - Survival after treatment of rabies with induction of coma
AU - Willoughby, Rodney E.
AU - Tieves, Kelly S.
AU - Hoffman, George M.
AU - Ghanayem, Nancy S.
AU - Amlie-Lefond, Catherine M.
AU - Schwabe, Michael J.
AU - Chusid, Michael J.
AU - Rupprecht, Charles E.
PY - 2005/6/16
Y1 - 2005/6/16
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/20444444376
UR - https://www.scopus.com/pages/publications/20444444376#tab=citedBy
U2 - 10.1056/NEJMoa050382
DO - 10.1056/NEJMoa050382
M3 - Article
C2 - 15958806
AN - SCOPUS:20444444376
SN - 0028-4793
VL - 352
SP - 2508
EP - 2514
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 24
ER -