Acute and critical care for rabies bitten patients and the different outcomes in a Family: A Post Exposure Prophylaxis (PEP) Failure report

Sara Nouri Basirat; Rouzbeh Bashar; Dr Behzad Pourhossain; Nasim Niknam; Mojtaba Sanji Rafsanjani; Mohammad Reza  Shirzadi; Farzaneh Sheikholeslami; Reza Farzad; Maryam Fazeli

doi:10.22037/jcma.v4i4.29172

Journal of Cellular & Molecular Anesthesia

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https://doi.org/10.22037/jcma.v4i4.29172

Acute and critical care for rabies bitten patients and the different outcomes in a Family: A Post Exposure Prophylaxis (PEP) Failure report

Author(s):

Sara Nouri Basirat^1,*,

Rouzbeh Bashar²,

Dr Behzad Pourhossain³,

Nasim Niknam⁴,

Mojtaba Sanji Rafsanjani⁵,

Mohammad Reza Shirzadi⁶,

Farzaneh Sheikholeslami⁷,

Reza Farzad⁷,

Maryam Fazeli⁸

1MSc, Researcher; Regenerative Medicine and Biomedical Innovation Lab, Pasteur Institute of Iran, Tehran, Iran

2DVM, PhD, Director of the National Center for Reference and Research on Rabies, Virology Department, Pasteur Institute of Iran, Tehran, Iran

3PhD, Researcher; Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

4MD, Resident in Medicine; Department of Internal Medicine, School of Medicine, Alborz University of Medical Science, Shahid Rajaei Heart Center, Karaj, Alborz, Iran

5MD, Assistant Professor; Emergency Department, Ali Ebn Abitaleb Hospital, Faculty of Medicine, Rafsanjan University of Medical Science, Rafsanjan, Kerman, Iran

6MD, Associate Professor; Zoonosis Control Department, Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran

7Virology Department, Pasteur Institute of Iran, Tehran, Iran

8PhD, Assistant Professor; Deputy Director of the National Center for Reference and Research on Rabies, Virology Department, Pasteur Institute of Iran, Tehran, Iran

Journal of Cellular & Molecular Anesthesia:Vol. 4, issue 4; e149595

Published online:Mar 24, 2020

Article type:Case Report

How to Cite:Sara Nouri BasiratRouzbeh BasharDr Behzad PourhossainNasim NiknamMojtaba Sanji RafsanjaniMohammad Reza ShirzadiFarzaneh SheikholeslamiReza FarzadMaryam Fazeliet al.Acute and critical care for rabies bitten patients and the different outcomes in a Family: A Post Exposure Prophylaxis (PEP) Failure report.J Cell Mol Anesth.4(4):e149595.https://doi.org/10.22037/jcma.v4i4.29172.

Abstract

Rabies is a zoonotic viral disease that spread via infected animal saliva. Rabies virus belongs to Lyssavirus genus (Rhabdoviridae family) and the disease is endemic in Iran. The disease causes a fatal encephalomyelitis by infecting the nervous system. Dogs are the most common source of human rabies cases. In this presentation, we had a 58-year-old man who had a dog bitten history on his face and hands with his other two family members with the same dog at the same time. They received post-exposure prophylaxis (PEP) as soon as possible (from day 0). Eighteen days after bitten the man hospitalized and died of rabies three days after hospitalization. Other two relatives were healthy without any rabies symptom. The man was an Iranian veteran with residual body insults during the attacks of chemical warfare from the combat front. Obtained data in this study suggested that the direct inoculation of the virus to the nerve and immune system inability in virus clearing system were possible etiologies of PEP failure in the reported case. Keywords: Rabies Virus, Immunoglobulin, Pre-Exposure Prophylaxis (PrEP), Immunosuppression

References

1.
References are in the PDF file of the article.

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Author(s):

Sara Nouri Basirat:[PubMed][Scholar]
Rouzbeh Bashar:[PubMed][Scholar]
Dr Behzad Pourhossain:[PubMed][Scholar]
Nasim Niknam:[PubMed][Scholar]
Mojtaba Sanji Rafsanjani:[PubMed][Scholar]
Mohammad Reza Shirzadi:[PubMed][Scholar]
Farzaneh Sheikholeslami:[PubMed][Scholar]
Reza Farzad:[PubMed][Scholar]
Maryam Fazeli:[PubMed][Scholar]