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Survival after treatment of rabies with induction of coma.
N Engl J Med. 2005 Jun 16; 352(24):2508-14.NEJM

Abstract

We report the survival of a 15-year-old girl in whom clinical rabies developed one month after she was bitten by a bat. Treatment included induction of coma while a native immune response matured; rabies vaccine was not administered. The patient was treated with ketamine, midazolam, ribavirin, and amantadine. Probable drug-related toxic effects included hemolysis, pancreatitis, acidosis, and hepatotoxicity. Lumbar puncture after eight days showed an increased level of rabies antibody, and sedation was tapered. Paresis and sensory denervation then resolved. The patient was removed from isolation after 31 days and discharged to her home after 76 days. At nearly five months after her initial hospitalization, she was alert and communicative, but with choreoathetosis, dysarthria, and an unsteady gait.

Authors+Show Affiliations

Department of Pediatric Infectious Diseases, Medical College of Wisconsin, Milwaukee, USA. rewillou@mail.mcw.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15958806

Citation

Willoughby, Rodney E., et al. "Survival After Treatment of Rabies With Induction of Coma." The New England Journal of Medicine, vol. 352, no. 24, 2005, pp. 2508-14.
Willoughby RE, Tieves KS, Hoffman GM, et al. Survival after treatment of rabies with induction of coma. N Engl J Med. 2005;352(24):2508-14.
Willoughby, R. E., Tieves, K. S., Hoffman, G. M., Ghanayem, N. S., Amlie-Lefond, C. M., Schwabe, M. J., Chusid, M. J., & Rupprecht, C. E. (2005). Survival after treatment of rabies with induction of coma. The New England Journal of Medicine, 352(24), 2508-14.
Willoughby RE, et al. Survival After Treatment of Rabies With Induction of Coma. N Engl J Med. 2005 Jun 16;352(24):2508-14. PubMed PMID: 15958806.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival after treatment of rabies with induction of coma. AU - Willoughby,Rodney E,Jr AU - Tieves,Kelly S, AU - Hoffman,George M, AU - Ghanayem,Nancy S, AU - Amlie-Lefond,Catherine M, AU - Schwabe,Michael J, AU - Chusid,Michael J, AU - Rupprecht,Charles E, PY - 2005/6/17/pubmed PY - 2005/6/23/medline PY - 2005/6/17/entrez SP - 2508 EP - 14 JF - The New England journal of medicine JO - N Engl J Med VL - 352 IS - 24 N2 - We report the survival of a 15-year-old girl in whom clinical rabies developed one month after she was bitten by a bat. Treatment included induction of coma while a native immune response matured; rabies vaccine was not administered. The patient was treated with ketamine, midazolam, ribavirin, and amantadine. Probable drug-related toxic effects included hemolysis, pancreatitis, acidosis, and hepatotoxicity. Lumbar puncture after eight days showed an increased level of rabies antibody, and sedation was tapered. Paresis and sensory denervation then resolved. The patient was removed from isolation after 31 days and discharged to her home after 76 days. At nearly five months after her initial hospitalization, she was alert and communicative, but with choreoathetosis, dysarthria, and an unsteady gait. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/15958806/Survival_after_treatment_of_rabies_with_induction_of_coma_ L2 - https://www.nejm.org/doi/10.1056/NEJMoa050382?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -