Badillo Reynaldo, Mantilla Julio César, Pradilla Gustavo
Departamento de Medicina Interna, Escuela de Medicina, Hospital Universitario de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia.
Biomedica. 2009 Jun;29(2):191-203.
Human rabies encephalitis by a vampire bat bite in an urban area of Colombia A case of rabies encephalitis is presented in a teenaged male, which developed four months after a bat bite in the urban area of Floridablanca, Santander Province, Colombia. The complex clinical manifestations prevented the confirmation of an antemortem diagnosis, principally because of the lengthy incubation period and the absence of other similar urban cases. Despite application of several therapies, including the Milwaukee protocol, the patient died 19 days after hospital admission. The autopsy revealed a necrotic, acute, pan-encephalitis of rabies virus etiology. The test of direct immunofluorescence in brain tissue was positive, as well as the biologic test in mice. Serological tests indicated it to be an antigenic variant type 3, whose main reservoir is the hematophagous vampire bat, Desmodus rotundus. This is probably the first case of bat-induced rabies reported in an urban community of Colombia and one of the few in Latin America. Although rabies encephalitis by a bat bite is rare, the case serves as a notice to health authorities and to the medical community to be alert to this risk.
哥伦比亚市区因吸血蝙蝠叮咬导致的人类狂犬病脑炎 本文报告了一例青少年男性狂犬病脑炎病例,该病例于哥伦比亚桑坦德省弗洛里达布兰卡市区被蝙蝠叮咬四个月后发病。复杂的临床表现使得生前诊断难以确诊,主要原因是潜伏期较长且当地城市没有其他类似病例。尽管采用了包括密尔沃基疗法在内的多种治疗方法,患者在入院19天后仍死亡。尸检显示为狂犬病病毒所致的坏死性、急性全脑炎。脑组织直接免疫荧光检测呈阳性,小鼠生物学检测也呈阳性。血清学检测表明其为3型抗原变异株,主要宿主是吸血蝙蝠圆叶吸血蝠。这可能是哥伦比亚城市社区报告的首例蝙蝠致狂犬病病例,也是拉丁美洲为数不多的此类病例之一。尽管蝙蝠叮咬导致的狂犬病脑炎罕见,但该病例提醒卫生当局和医学界对此风险保持警惕。