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Case Reports
. 2005 Jun 16;352(24):2508-14.
doi: 10.1056/NEJMoa050382.

Survival after treatment of rabies with induction of coma

Rodney E Willoughby Jr  1 , Kelly S Tieves, George M Hoffman, Nancy S Ghanayem, Catherine M Amlie-Lefond, Michael J Schwabe, Michael J Chusid, Charles E Rupprecht
Affiliations
Free article
Case Reports

Survival after treatment of rabies with induction of coma

Rodney E Willoughby Jr et al. N Engl J Med. .
Free article

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.

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Comment in

  • Recovery from rabies.
    Jackson AC. Jackson AC. N Engl J Med. 2005 Jun 16;352(24):2549-50. doi: 10.1056/NEJMe058092. N Engl J Med. 2005. PMID: 15958812 No abstract available.
  • Survival after treatment of rabies.
    Hemachudha T, Wilde H. Hemachudha T, et al. N Engl J Med. 2005 Sep 8;353(10):1068-9; author reply 1068-9. doi: 10.1056/NEJMc051932. N Engl J Med. 2005. PMID: 16148297 No abstract available.
  • Long-term follow-up after treatment of rabies by induction of coma.
    Hu WT, Willoughby RE Jr, Dhonau H, Mack KJ. Hu WT, et al. N Engl J Med. 2007 Aug 30;357(9):945-6. doi: 10.1056/NEJMc062479. N Engl J Med. 2007. PMID: 17761604 No abstract available.

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