Netravathi M, Udani V, Mani R, Gadad V, Ashwini M, Bhat M, Mehta S, Chowdhary A, Pal P, Madhusudana S, Satishchandra P, 2015. Unique clinical and imaging findings in a first ever documented PCR positive rabies survival patient: a case report. J Clin Virol 70: 83–88.
World Health Organization, 2015. Rabies: Epidemiology and Burden of Disease. Available at: http://www.who.int/rabies/epidemiology/en/. Accessed August 28, 2015.
De Serres G, Dallaire F, Côte M, Skowronski DM, 2008. Bat rabies in the United States and Canada from 1950 through 2007: human cases with and without bat contact. Clin Infect Dis 46: 1329–1337.
Blanton JD, Dyer J, McBrayer J, Rupprecht CE, 2012. Rabies surveillance in the United States during 2011. J Am Vet Med Assoc 241: 712–722.
Centers for Disease Control and Prevention, 2011. Rabies Surveillance Data in the United States. Available at: http://www.cdc.gov/rabies/location/usa/surveillance/index.html. Accessed August 25, 2015.
Centers for Disease Control and Prevention, 2012. Human Rabies. Available at: http://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html. Accessed August 25, 2015.
Udow SJ, Marrie RA, Jackson AC, 2013. Clinical features of dog- and bat-acquired rabies in humans. Clin Infect Dis 57: 689–696.
Hemachudha T, Ugolini G, Wacharapluesadee S, Sungkarat W, Shuangshoti S, Laothamatas J, 2013. Human rabies: neuropathogenesis, diagnosis, and management. Lancet Neurol 12: 498–513.
Winkler WG, Baker EF, Hopkins CC, 1972. An outbreak of non-bite transmitted rabies in a laboratory animal colony. Am J Epidemiol 95: 267–277.
Davis AD, Rudd RJ, Bowen RA, 2007. Effects of aerosolized rabies virus exposure on bats and mice. J Infect Dis 195: 1144–1150.
Gibbons RV, 2002. Cryptogenic rabies, bats, and the question of aerosol transmission. Ann Emerg Med 39: 528–536.
Watson HD, Tignor GH, Smith AL, 1981. Entry of rabies virus into the peripheral nerves of mice. J Gen Virol 56: 372–382.
Murphy FA, Bauer SP, 1974. Early street rabies virus infection in striated muscle and later progression to the central nervous system. Intervirology 3: 256–268.
Murphy FA, Bauer SP, Harrison AK, Winn WC Jr, 1973. Comparative pathogenesis of rabies and rabies-like viruses. Viral infection and transit from inoculation site to the central nervous system. Lab Invest 28: 361–376.
Fu ZF, Jackson AC, 2005. Neuronal dysfunction and death in rabies virus infection. J Neurovirol 11: 101–106.
Centers for Disease Control and Prevention, 2009. Human rabies—Missouri, 2008. MMWR 58: 1207–1209.
Centers for Disease Control and Prevention, 2011. Human rabies—Wisconsin, 2010. MMWR 60: 1164–1166.
Kuzmin IV, Bozick B, Guagliardo SA, Kunkel R, Shak JR, Tong S, Rupprecht CE, 2011. Bats, emerging infectious diseases, and the rabies paradigm revisited. Emerg Health Threats J 4: 7159.
McAllister CT, Bursey CR, Robison HW, 2011. A new host and three new geographic distribution records for trematodes (Digenea: Lecithodendriidae) from the eastern pipistrelle, Perimyotis subflavus (Chiroptera: Vespertilionidae), in Arkansas, USA. Comp Parasitol 78: 193–199.
Consales C, Bolzan V, 2007. Rabies review: immunopathology, clinical aspects and treatment. J Venom Anim Toxins Incl Trop Dis 13: 5–38.
Morimoto K, Patel M, Corisdeo S, Hooper DC, Fu ZF, Rupprecht CE, Koprowski H, Dietzschold B, 1996. Characterization of a unique variant of bat rabies virus responsible for newly emerging human cases in North America. Proc Natl Acad Sci USA 93: 5653–5658.
Velasco-Villa A, Reeder SA, Orciari LA, Yager PA, Franka R, Blanton JD, Zuckero L, Hunt P, Oertli EH, Robinson LE, Rupprecht CE, 2008. Enzootic rabies elimination from dogs and reemergence in wild terrestrial carnivores, United States. Emerg Infect Dis 14: 1849.
Popova NK, 2008. From gene to aggressive behavior: the role of brain serotonin. Neurosci Behav Physiol 38: 471–475.
Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM, 2003. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM 96: 635–642.
Mestres J, Seifert SA, Oprea TI, 2011. Linking pharmacology to clinical reports: cyclobenzaprine and its possible association with serotonin syndrome. Clin Pharmacol Ther 90: 662–665.
Kobayashi H, Hasegawa Y, Ono H, 1996. Cyclobenzaprine, a centrally acting muscle relaxant, acts on descending serotonergic systems. Eur J Pharmacol 311: 29–35.
Jackson AC, 2015. Diabolical effects of rabies encephalitis. J Neurovirol 22: 8–13.
Willoughby RE, Opladen T, Maier T, Rhead W, Schmiedel S, Hoyer J, Drosten C, Rupprecht CE, Hyland K, Hoffmann GF, 2009. Tetrahydrobiopterin deficiency in human rabies. J Inherit Metab Dis 32: 65–72.
Fava GA, Gatti A, Belaise C, Guidi J, Offidani E, 2015. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychother Psychosom 84: 72–81.
Caviness JN, Brown P, 2004. Myoclonus: current concepts and recent advances. Lancet Neurol 3: 598–607.
Deuschl G, Raethjen J, Lindemann M, Krack P, 2001. The pathophysiology of tremor. Muscle Nerve 24: 716–735.
Hemachudha T, Laothamatas J, Rupprecht CE, 2002. Human rabies: a disease of complex neuropathogenetic mechanisms and diagnostic challenges. Lancet Neurol 1: 101–109.
Centers for Disease Control and Prevention, 2010. Human rabies—Kentucky/Indiana, 2009. MMWR 59: 393–396.
Centers for Disease Control and Prevention, 2012. U.S.-acquired human rabies with symptom onset and diagnosis abroad, 2012. MMWR 61: 777–781.
Burton EC, Burns DK, Opatowsky MJ, El-Feky WH, Fischbach B, Melton L, Sanchez E, Randall H, Watkins DL, Chang J, Klintmalm G, 2005. Rabies encephalomyelitis: clinical, neuroradiological, and pathological findings in 4 transplant recipients. Arch Neurol 62: 873–882.
Chen YG, Kan LP, Lee CH, Lin SH, Chu DM, Chang FY, Yang YS, 2015. Symptomatic hypercalcemia in a rabies survivor underwent hemodialysis. Hemodial Int 19: 347–351.
Centers for Disease Control and Prevention, 1995. Human rabies—Alabama, Tennessee, and Texas, 1994. MMWR 44: 269–272.
Aramburo A, Willoughby RE, Bollen AW, Glaser CA, Hsieh CJ, Davis SL, Martin KW, Roy-Burman A, 2011. Failure of the Milwaukee protocol in a child with rabies. Clin Infect Dis 53: 572–574.
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Human rabies is a fatal disease, transmitted by saliva of infected animals, and the diagnosis requires a high index of suspicion. Very few cases are reported annually in the United States. We present a case of human rabies without a clear exposure history that masqueraded as serotonin syndrome.
Authors' addresses: Hariharan Regunath Division of Pulmonary Critical Care and Environmental Medicine, Department of Medicine, University of Missouri, Columbia, MO, and Division of Infectious Diseases, Department of Medicine, University of Missouri, Columbia, MO, E-mail: regunathh@health.missouri.edu. Bhavana Chinnakotla, Department of Medicine, University of Missouri, Columbia, MO, E-mail: bhavana611@gmail.com. Christian Rojas-Moreno and William Salzer, Division of Infectious Diseases, Department of Medicine, University of Missouri, Columbia, MO, E-mails: rojasch@health.missouri.edu and salzerw@health.missouri.edu. Natalie J. Hughes, Department of Medicine, University of Florida, Gainesville, FL, E-mail: natalie.hughes@medicine.ufl.edu. Harbaksh Sangha, Division of Pulmonary Critical Care and Environmental Medicine, Department of Medicine, University of Missouri, Columbia, MO, E-mail: sanghah@health.missouri.edu.
Netravathi M, Udani V, Mani R, Gadad V, Ashwini M, Bhat M, Mehta S, Chowdhary A, Pal P, Madhusudana S, Satishchandra P, 2015. Unique clinical and imaging findings in a first ever documented PCR positive rabies survival patient: a case report. J Clin Virol 70: 83–88.
World Health Organization, 2015. Rabies: Epidemiology and Burden of Disease. Available at: http://www.who.int/rabies/epidemiology/en/. Accessed August 28, 2015.
De Serres G, Dallaire F, Côte M, Skowronski DM, 2008. Bat rabies in the United States and Canada from 1950 through 2007: human cases with and without bat contact. Clin Infect Dis 46: 1329–1337.
Blanton JD, Dyer J, McBrayer J, Rupprecht CE, 2012. Rabies surveillance in the United States during 2011. J Am Vet Med Assoc 241: 712–722.
Centers for Disease Control and Prevention, 2011. Rabies Surveillance Data in the United States. Available at: http://www.cdc.gov/rabies/location/usa/surveillance/index.html. Accessed August 25, 2015.
Centers for Disease Control and Prevention, 2012. Human Rabies. Available at: http://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html. Accessed August 25, 2015.
Udow SJ, Marrie RA, Jackson AC, 2013. Clinical features of dog- and bat-acquired rabies in humans. Clin Infect Dis 57: 689–696.
Hemachudha T, Ugolini G, Wacharapluesadee S, Sungkarat W, Shuangshoti S, Laothamatas J, 2013. Human rabies: neuropathogenesis, diagnosis, and management. Lancet Neurol 12: 498–513.
Winkler WG, Baker EF, Hopkins CC, 1972. An outbreak of non-bite transmitted rabies in a laboratory animal colony. Am J Epidemiol 95: 267–277.
Davis AD, Rudd RJ, Bowen RA, 2007. Effects of aerosolized rabies virus exposure on bats and mice. J Infect Dis 195: 1144–1150.
Gibbons RV, 2002. Cryptogenic rabies, bats, and the question of aerosol transmission. Ann Emerg Med 39: 528–536.
Watson HD, Tignor GH, Smith AL, 1981. Entry of rabies virus into the peripheral nerves of mice. J Gen Virol 56: 372–382.
Murphy FA, Bauer SP, 1974. Early street rabies virus infection in striated muscle and later progression to the central nervous system. Intervirology 3: 256–268.
Murphy FA, Bauer SP, Harrison AK, Winn WC Jr, 1973. Comparative pathogenesis of rabies and rabies-like viruses. Viral infection and transit from inoculation site to the central nervous system. Lab Invest 28: 361–376.
Fu ZF, Jackson AC, 2005. Neuronal dysfunction and death in rabies virus infection. J Neurovirol 11: 101–106.
Centers for Disease Control and Prevention, 2009. Human rabies—Missouri, 2008. MMWR 58: 1207–1209.
Centers for Disease Control and Prevention, 2011. Human rabies—Wisconsin, 2010. MMWR 60: 1164–1166.
Kuzmin IV, Bozick B, Guagliardo SA, Kunkel R, Shak JR, Tong S, Rupprecht CE, 2011. Bats, emerging infectious diseases, and the rabies paradigm revisited. Emerg Health Threats J 4: 7159.
McAllister CT, Bursey CR, Robison HW, 2011. A new host and three new geographic distribution records for trematodes (Digenea: Lecithodendriidae) from the eastern pipistrelle, Perimyotis subflavus (Chiroptera: Vespertilionidae), in Arkansas, USA. Comp Parasitol 78: 193–199.
Consales C, Bolzan V, 2007. Rabies review: immunopathology, clinical aspects and treatment. J Venom Anim Toxins Incl Trop Dis 13: 5–38.
Morimoto K, Patel M, Corisdeo S, Hooper DC, Fu ZF, Rupprecht CE, Koprowski H, Dietzschold B, 1996. Characterization of a unique variant of bat rabies virus responsible for newly emerging human cases in North America. Proc Natl Acad Sci USA 93: 5653–5658.
Velasco-Villa A, Reeder SA, Orciari LA, Yager PA, Franka R, Blanton JD, Zuckero L, Hunt P, Oertli EH, Robinson LE, Rupprecht CE, 2008. Enzootic rabies elimination from dogs and reemergence in wild terrestrial carnivores, United States. Emerg Infect Dis 14: 1849.
Popova NK, 2008. From gene to aggressive behavior: the role of brain serotonin. Neurosci Behav Physiol 38: 471–475.
Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM, 2003. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM 96: 635–642.
Mestres J, Seifert SA, Oprea TI, 2011. Linking pharmacology to clinical reports: cyclobenzaprine and its possible association with serotonin syndrome. Clin Pharmacol Ther 90: 662–665.
Kobayashi H, Hasegawa Y, Ono H, 1996. Cyclobenzaprine, a centrally acting muscle relaxant, acts on descending serotonergic systems. Eur J Pharmacol 311: 29–35.
Jackson AC, 2015. Diabolical effects of rabies encephalitis. J Neurovirol 22: 8–13.
Willoughby RE, Opladen T, Maier T, Rhead W, Schmiedel S, Hoyer J, Drosten C, Rupprecht CE, Hyland K, Hoffmann GF, 2009. Tetrahydrobiopterin deficiency in human rabies. J Inherit Metab Dis 32: 65–72.
Fava GA, Gatti A, Belaise C, Guidi J, Offidani E, 2015. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychother Psychosom 84: 72–81.
Caviness JN, Brown P, 2004. Myoclonus: current concepts and recent advances. Lancet Neurol 3: 598–607.
Deuschl G, Raethjen J, Lindemann M, Krack P, 2001. The pathophysiology of tremor. Muscle Nerve 24: 716–735.
Hemachudha T, Laothamatas J, Rupprecht CE, 2002. Human rabies: a disease of complex neuropathogenetic mechanisms and diagnostic challenges. Lancet Neurol 1: 101–109.
Centers for Disease Control and Prevention, 2010. Human rabies—Kentucky/Indiana, 2009. MMWR 59: 393–396.
Centers for Disease Control and Prevention, 2012. U.S.-acquired human rabies with symptom onset and diagnosis abroad, 2012. MMWR 61: 777–781.
Burton EC, Burns DK, Opatowsky MJ, El-Feky WH, Fischbach B, Melton L, Sanchez E, Randall H, Watkins DL, Chang J, Klintmalm G, 2005. Rabies encephalomyelitis: clinical, neuroradiological, and pathological findings in 4 transplant recipients. Arch Neurol 62: 873–882.
Chen YG, Kan LP, Lee CH, Lin SH, Chu DM, Chang FY, Yang YS, 2015. Symptomatic hypercalcemia in a rabies survivor underwent hemodialysis. Hemodial Int 19: 347–351.
Centers for Disease Control and Prevention, 1995. Human rabies—Alabama, Tennessee, and Texas, 1994. MMWR 44: 269–272.
Aramburo A, Willoughby RE, Bollen AW, Glaser CA, Hsieh CJ, Davis SL, Martin KW, Roy-Burman A, 2011. Failure of the Milwaukee protocol in a child with rabies. Clin Infect Dis 53: 572–574.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 557 | 499 | 292 |
Full Text Views | 304 | 5 | 0 |
PDF Downloads | 112 | 5 | 0 |