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Case Reports
. 2009 Jul 28;3(7):e428.
doi: 10.1371/journal.pntd.0000428.

Fatal human rabies due to Duvenhage virus from a bat in Kenya: failure of treatment with coma-induction, ketamine, and antiviral drugs

Pieter-Paul A M van Thiel  1 , Rob M A de Bie, Filip Eftimov, Robert Tepaske, Hans L Zaaijer, Gerard J J van Doornum, Martin Schutten, Albert D M E Osterhaus, Charles B L M Majoie, Eleonora Aronica, Christine Fehlner-Gardiner, Alex I Wandeler, Piet A Kager
Affiliations
Case Reports

Fatal human rabies due to Duvenhage virus from a bat in Kenya: failure of treatment with coma-induction, ketamine, and antiviral drugs

Pieter-Paul A M van Thiel et al. PLoS Negl Trop Dis. .
No abstract available

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. MRI brain on day 6 of admission.
Axial T2-weighted images in a patient with rabies due to Duvenhage virus infection, at day 6 after admission; hyperintense signal in the posterior part of the medulla oblongata (arrow).
Figure 2
Figure 2. MRI brain on day 16 of admission (4 days before death).
Axial T-2 weighted images in a patient with rabies due to Duvenhage virus infection, at day 17 after admission show increased signal in the posterior part of the medulla oblongata (arrow) and in the basal ganglia (arrows).
Figure 3
Figure 3. Histopathology rabies encephalitis due to Duvenhage virus.
Rabies encephalitis (lyssavirus; genotype 4) brain pathology: cerebral cortex and anti-RNP Immunohistochemistry. (A) (HE staining): frontal cortex: extensive neuropil vacuolization and neuronal cell loss. (B) Few residual cortical neurons (arrows). (C) (HE staining): perivascular lymphocytic inflammatory infiltrates (arrows). (D and E) Anti-RNP immunoreactivity within the frontal cortex. Several neuronal cells show immunopositivity (arrows and insert in [E]) with multiple antigenic masses present in the neuronal cytoplasm, as well as in dendrites and axon. Scale bar: (A, B) 100 µm; (C, D) 60 µm; (E) 40 µm; insert in (E): 12 µm.
Figure 4
Figure 4. Immunofluorescence tests with antirabies nucleocapside conjugate.
Immunofluorescence of murine neuroblastoma cells using antirabies nucleocapside conjugate (Bio-Rad). The arrow points to cells with positive green immunofluorescence. The right picture is a magnification of the left with the scale bar.
Figure 5
Figure 5. Lyssa virus phylogenetic tree with presented rabies case embedded.
Phylogenetic tree of the presented rabies case (sequence arrowed) and representative Lyssavirus genomes. Mega 3.1 tree (neighbour joining, Kimura 2–parameter, 1,000 bootstrap values) based on a 367–base pair fragment in the nucleoprotein region. Bootstrap percentages higher than 75% are indicated. Genotype 1  =  rabies virus (RV); Genotype 2  =  Lagos bat virus (LBV); Genotype 3  =  Mokola virus (MV); Genotype 4  =  Duvenhage virus (DV); Genotype 5  =  European bat lyssavirus (EBLV) 1a and 1b; Genotype 6  =  European bat lyssavirus (EBVL) 2a and 2b; Genotype 7  =  Australian bat lyssavirus (ABLV). Present virus isolate in Genotype 4: DV E2007011420 (arrowed).
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References

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