Cuela-Martínez Karen Tatiana, Peña-Vásquez Walter, Vásquez-Paz Héctor, Virú-Loza Manuel André
Hospital Nacional Dos de Mayo, Lima, Peru.
Universidad San Ignacio de Loyola, Lima, Peru.
Sage Open Pediatr. 2025 Feb 25;12:30502225251318115. doi: 10.1177/30502225251318115. eCollection 2025 Jan-Dec.
We report the first case of human rabies in a child from Amazonas after 10 years without an outbreak. An 8-year-old girl was admitted to the local hospital because of headache, myalgia, diarrhea, fever, and vomiting during the previous 4 days. Meningoencephalitis was suspected, and empiric therapy with ceftriaxone and vancomycin was started. However, in the following 3 days, she also presented progressive lower extremities weakness, behavioral changes, photophobia, irritability, sialorrhea, and hallucinations. Thus, she was transferred to our hospital. Phenytoin, dexamethasone, mannitol, and acyclovir were started, and ceftriaxone was continued. Five days later, the mother recalled that the patient was bitten by a feral cat. Thus, human rabies immunoglobulin serum was administered immediately. However, 2 days later, the patient died. Post-mortem brain direct immunofluorescence study confirmed human rabies. Awareness campaigns can be lifesaving since more than 99% of deaths can be prevented if timely treatment is provided.
我们报告了10年来亚马孙地区无狂犬病爆发后出现的首例儿童人类狂犬病病例。一名8岁女孩因前4天出现头痛、肌痛、腹泻、发热和呕吐被送往当地医院。怀疑为脑膜脑炎,开始使用头孢曲松和万古霉素进行经验性治疗。然而,在接下来的3天里,她还出现了进行性下肢无力、行为改变、畏光、易怒、流涎和幻觉。因此,她被转到我们医院。开始使用苯妥英钠、地塞米松、甘露醇和阿昔洛韦,并继续使用头孢曲松。5天后,母亲回忆起患者曾被一只野猫咬伤。因此,立即注射了人狂犬病免疫球蛋白血清。然而,2天后,患者死亡。尸检脑直接免疫荧光研究证实为人类狂犬病。提高认识的宣传活动可能会挽救生命,因为如果及时治疗,超过99%的死亡是可以预防的。