Rabies immune globulin/rabies vaccine
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Lack of efficacy and vaccine failure: case report A 9-year-old girl did not respond to rabies immune globulin and exhibited vaccine failure following administration of rabies vaccine. The girl was admitted to a hospital in Romania in 2010 due to a suspicion of acute encephalitis. Following a review of her medical history and clinical examination, rabies encephalitis was suspected. She was found to have multiple potential lesions, for which she had not received preventive anti-tetanus or anti-rabies immunisation. Multiple investigations suggested viral encephalitis, possibly rabies encephalitis, paralytic form. Other viral aetiologies were ruled out. Therefore, she was administered rabies immune globulin [anti-rabies immunoglobulin] with sensitivity testing and desensitisation; which was followed by rabies vaccine [anti-rabies vaccination] on days 0, 3, 7, 14 and 28 [routes and dosages not stated]. She also received aciclovir, dexamethasone, non-specific human immunoglobulin, hydroelectrolytic balancing, acidobasal and symptomatic drugs, and cerebral depletives, including furosemide and mannitol. However, her condition progressively worsened over the subsequent days, necessitating orotracheal intubation and mechanical ventilation under deep sedation. The condition was further complicated by progressive degradation and secondary infections resulting from ventilatory prosthesis, including acute bronchopneumonia, as well as acute liver failure and haematologic changes in the form of severe anaemia and thrombocytopenia, resulting in her death after 3 months of admission. Post-mortem necropsy examination confirmed the clinical suspicion of rabies. Jugulete G, et al. Rabies encephalomyelitis in children-paralytic form. Case report. Romanian Journal of Legal Medicine 28: 218-222, No. 2, Jan 2020. Available from: URL: 803500041 http://doi.org/10.4323/rjlm.2020.218
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Reactions 5 Sep 2020 No. 1820
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