Abstract

MANTILLA, Julio Cesar; SIERRA, Julián Camilo; GARCIA, Ernesto  and  PRADILLA, Gustavo. Paralytic form of a case of human rabies transmitted by bat, simulated Guillain Barre Syndrome: Presentation of an autopsy case. Rev. Univ. Ind. Santander. Salud [online]. 2010, vol.42, n.2, pp.139-151. ISSN 0121-0807.

Introduction: Rabies is fatal zoonoses caused by an RNA virus of the gender Lyssavirus, it is transmitted to humans through the saliva of infected animal bite, contamination of an open wound, scratch, abrasion or laceration of a mucous membrane or infected nervous tissue. It has been found further transmission to humans by inhalation of rabies virus present in aerosol suspended in the air of caves where bats live in large numbers, as well as in laboratory accidents and by transplanting organs infected with the virus. This penetrates from the injury to the nerve endings and by retrograde axonal transport enters to the Central Nervous System whose commitment explains the clinical manifestations in its encephalitic and paralytic forms, the latter of which is characterized by loss of force initiated in the bitten limb and spread to the other limns as a flaccid paralysis, resembling a Guillain Barré syndrome (GBS). Objective: To present a case of a patient female, resident from a urban area of Barrancabermeja, died of rabies, whose clinic picture was diagnosed as a GBS and necropsy revealed a rabies encephalitis. Results: Adult female with clinical features of flaccid quadriparesis, dysphagia, and dyspnea, diagnosed as GBS and hospitalized in the intensive care unit of a health institution level III of the city of Bucaramanga, who died 23 days after starting his neurological symptoms. By questioning her family it was established a bat bite 2 months before and autopsy determined rabies encephalitis. Discussion: This report seeks to draw attention on a new episode of human rabies transmitted by bats in an urban area of the department of Santander, Colombia to carry out preventive activities to prevent the occurrence of new cases and alert medical personnel to act diligently and early to any possible rabies accident, and that improper handling of these can contribute to a new case of fatal disease. Also, given the frequency of cases of GBS in our hospitals to bear in mind in its differential diagnosis, the rabies in its paralytic form and insist on a history of being bitten by bats or other animals thus have been months or even years before. Salud UIS 2010; 42: 139-151.

Keywords : Rabies; Guillain Barré Syndrome; bat; autopsy; Santander; Colombia.

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