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改良密尔沃基方案在巴西原住民儿童狂犬病治疗中的应用:病例报告。

Adapted Milwaukee protocol for rabies treatment in a Brazilian indigenous child: case report.

机构信息

Postgraduate Program in Collective Health, Oswaldo Cruz Foundation, René Rachou Institute, Belo Horizonte, Minas Gerais, Brazil.

Special Indigenous Health District of Minas Gerais and Espírito Santo, Governador Valadares, Minas Gerais, Brazil.

出版信息

Virol J. 2024 Oct 25;21(1):265. doi: 10.1186/s12985-024-02536-2.

Abstract

BACKGROUND

This case report describes the treatment of a 12-year-old indigenous Brazilian girl from the Maxakali group with rabies using the adapted Milwaukee Protocol.

CASE PRESENTATION

The patient suffered a superficial bat bite on her right elbow, reported on April 5, 2022. Despite receiving immunoglobulin, a vaccine, and antiviral medications such as amantadine and sapropterin, the patient succumbed to the disease 25 days after hospital admission. The report highlights the inherent challenges in treating rabies due to the virus's neurotropic nature and the difficulties in delivering antiviral drugs to the central nervous system. The case underscores the need for early antiviral intervention and calls for more studies to validate and improve treatment protocols for rabies in vulnerable populations, particularly those with genetic and immunological susceptibilities like the Maxakali indigenous group.

CONCLUSION

The findings suggest that while the Milwaukee Protocol offers some hope, significant obstacles remain in achieving successful outcomes in rabies cases.

摘要

背景

本病例报告描述了采用改良的密尔沃基方案治疗一名来自马克萨斯卡里族的 12 岁巴西原住民狂犬病患者的情况。

病例介绍

患者于 2022 年 4 月 5 日报告右肘被蝙蝠轻微咬伤。尽管患者接受了免疫球蛋白、疫苗和抗病毒药物(如金刚烷胺和沙丙蝶呤)治疗,但在入院后 25 天仍死于该病。该报告强调了由于病毒的嗜神经性和向中枢神经系统输送抗病毒药物的困难,治疗狂犬病所固有的挑战。该病例强调了早期抗病毒干预的必要性,并呼吁开展更多研究,以验证和改进针对易感染人群(如马克萨斯卡里原住民群体)的狂犬病治疗方案,这些人群具有遗传和免疫易感性。

结论

研究结果表明,尽管密尔沃基方案带来了一些希望,但在狂犬病病例中取得成功结果仍存在重大障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e093/11515255/be3d65bf2b89/12985_2024_2536_Fig1_HTML.jpg

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