Title: Impaired consciousness revealing rabies encephalitis : A pediatric case
Authors: Abdallah Said ABDALLAH , Fatima Zohra BENBRAHIM, Lina BELKOUCHI, Nazik ALLALI , Siham EL HADDAD, Latifa CHAT
Volume: 9
Issue: 2
Pages: 24-27
Publication Date: 2025/02/28
Abstract:
: Rabies encephalitis is one of the most fatal neurotropic diseases, with near-certain fatality once symptoms develop. In rabies-endemic regions such as Morocco, where dogs are the primary source of transmission, imaging plays a critical role in diagnosis. MRI finding is very helpful in detecting central nervous system (CNS) involvement and distinguishing rabies from other encephalitis. We report the case of a 6-year-old boy who developed rapidly fatal rabies encephalomyelitis following a dog bite, despite post-exposure prophylaxis (PEP). On admission, brain MRI revealed bilateral, symmetrical hyperintensities in the thalami, basal ganglia, midbrain, and pons on T2-weighted and FLAIR sequences, without abnormal enhancement on post-contrast images. MRI is the preferred imaging modality for identifying CNS involvement in cases of rabies encephalitis. Typical MRI findings rabies encephalitis primarily affects the gray matter. Early detection of these MRI abnormalities is crucial for guiding diagnosis and differentiating rabies from other treatable causes of encephalitis. Despite advances in imaging, the prognosis for rabies encephalitis remains grim, highlighting the urgent need for novel therapeutic strategies to combat this fatal disease.