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Patient case: Rabies in a Rural Community

Discussion

A 32-year-old male farmer from a remote village presented to the local clinic with complaints of fever, headache, and muscle weakness. Four weeks prior, he was bitten on the hand by a stray dog while working in his field. The wound, though initially painful, was not properly treated, as the patient believed it would heal on its own.

After a week of minor discomfort, he began experiencing intermittent bouts of agitation, difficulty swallowing, and hypersalivation. His family noted that he had become irritable and increasingly afraid of water, avoiding drinking even small amounts. As his symptoms worsened, he developed episodes of confusion and hallucinations.

Upon arrival at the clinic, the patient exhibited signs of encephalitis, including disorientation, hyperactivity, and periods of extreme anxiety. The healthcare provider recognized the possibility of rabies based on the patient's history of an untreated dog bite and the progression of neurological symptoms. Unfortunately, the patient had not received post-exposure prophylaxis at the time of the bite.

Despite supportive care, the patient's condition deteriorated rapidly, and he succumbed to the infection within a few days. The case underscores the critical need for early medical intervention and vaccination in animal bite incidents, particularly in rural areas with limited access to healthcare.

Questions
1. What was the most likely source of infection in this patient?

a). Contaminated food

b). Insect bite

c). Dog bite

d). Contact with another infected person

 

 

 

 

 

2. What symptoms did the patient exhibit that are characteristic of rabies?

a). Fever, cough, and joint pain

b). Hyper salivation, fear of water, and confusion

c). Chest pain, shortness of breath, and rash

d). Diarrhoea, abdominal pain, and vomiting

3. Which critical step in rabies management was missed in this case?

a). Administering antibiotics immediately after the bite

b). Wound cleaning and tetanus vaccination

c). Post-exposure prophylaxis (PEP) after the dog bite

d). Monitoring the dog for 10 days

4. What is the outcome of rabies once neurological symptoms have appeared?

a). Recovery is possible with immediate surgery

b). The disease is often self-limiting

c). It is almost always fatal without early intervention

d). The symptoms will improve with rest and hydration

Reveal answers

Answers

  1. c). Dog bite
  2. b). Hyper salivation, fear of water, and confusion
  3. c). Post-exposure prophylaxis (PEP) after the dog bite
  4. c). It is almost always fatal without early intervention