1/4. Imaging findings in rabies encephalitis.SUMMARY: Rabies encephalitis is perhaps one of the few infectious diseases that command attention and fear not only from the layman but also from physicians. The unique mode of transmission, the virtually exclusive neurotransmission shown by the agent, and the complete hopelessness of the established disease sets rabies apart from other zoonoses transmitted to man. Rabies encephalitis is a fatal disease and its diagnosis is usually based on the clinical presentations and findings. Hence, imaging in rabies is seldom done, and imaging findings in rabies encephalitis have rarely been described. We present the imaging findings in two confirmed cases of rabies encephalitis in which antemortem diagnosis was obtained by corneal impression smears showing the presence of viral antigens. The differential diagnosis of the imaging findings as well as the role and the relevance of imaging in the diagnosis of this disease are discussed. The current literature on the subject is also reviewed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Pneumomediastinum as initial presentation of paralytic rabies: a case report.BACKGROUND: Rabies is readily diagnosed when it presents as the classic furious form. Paralytic and atypical forms can pose significant problems in diagnosis. Catastrophic incidents included 7 organ transplant recipients who died of rabies recently in united states and germany. Although rabies remains top in the lists of differential diagnosis of encephalitis in rabies endemic area, its complication may divert physicians from making a relevant management. We encountered an unusual case of paralytic rabies who presented with spontaneous pneumomediastinum. CASE PRESENTATION: A young male presented with fever and dysphagia. There was a history of fluctuating consciousness and aerophobia but they were absent or could not be demonstrated at the time of admission. He exhibited subcutaneous chest wall emphysema and was found to have pneumomediastinum which resulted in surgical intervention. He developed paralysis followed by seizures during postoperative period. diagnosis was confirmed by demonstration of rabies rna in saliva during the preterminal phase and by the autopsy. Over 200 hospital staff subsequently received rabies postexposure prophylaxis. CONCLUSION: Spontaneous pneumomediastinum can be a rare complication of rabies. It may lead clinicians to perform inappropriate treatment, particularly when phobic spasms are not present and agitation is not prominent. High level of awareness of rabies in any patient with confusion albeit subtle or with any obscure neurological presentations such as difficulty swallowing with no identifiable causes must be borne in mind.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. Human rabies: a review.Human rabies is a rarely observed but frequently prophylaxed disease in north america. Presented in this review is a typical emergency department case and a summary of the epidemiology of the rabies virus, its clinical appearances, diagnosis, and management. Emphasis is placed on issues pertinent to the emergency physician practicing in the united states. Current recommendations for the administration of both active and passive immunotherapy for preexposure and postexposure prophylaxis are discussed. A treatment algorithm to aid in the decisions faced by a practicing physician regarding proper animal management and patient therapy and future prospects for the control of rabies in wild animal populations are also included.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
4/4. Childhood risks from the ferret.The ferret is becoming an increasingly popular pet, yet the dangers of ferret ownership remain unrecognized by physicians and the general public. Reported are three incidents of ferret attacks in a 3-month period of time. The risk of attack is greatest in infants and small children. Wounds caused by ferret attacks must be evaluated for injury, infection, and rabies prophylaxis. Such attacks should be reported to animal control authorities. physicians need to recognize the ferret as a risk to children.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |