Findings that shed new light on the possible pathogenesis of a disease or an adverse effect: Atypical rabies with MRI findings: clue to the diagnosis

摘要

Rabies is known for most as a fatal infectious disease, mainly transmitted to both humans and animals through bites by rabid animals. In its classical form, rabies is well recognised, but when it presents atypically in paralytic form, it may become difficult to distinguish from Guillain–Barré syndrome (GBS) or myelitis, particularly where history is not forthcoming or concealed. The authors report here an atypical case of paralytic rabies presenting with descending paralysis followed by furious form where clue to suspicion was MRI findings. Imaging in rabies is seldom done. MRI findings of rabies encephalitis are well known, but in myelitis these need to be further characterised. The authors present MRI findings in a confirmed case of rabies myelitis. The differential diagnosis of the imaging findings as well as the role and the relevance of imaging in the diagnosis of this disease are discussed.