Recovery from rabies, a universally fatal disease

BACKGROUND Rabies is a zoonosis transmitted via the bites of various mammals, primarily dogs and bats. Known since antiquity, this disease may have the deadliest human fatality rates and is responsible for approximately 65,000 deaths worldwide per year. CASE PRESENTATION We report the case details of a 13-year-old boy from India belonging to a South Asian ethnicity, who presented with altered sensorium one month following a dog bite. He did not receive the active rabies immunization and was managed with supportive therapy. The patient had extensive T2W (T2 weighted)/fluid attenuation and inversion recovery (FLAIR) hyper intensities involving the deep gray matter of the cerebral hemispheres, hippocampus, brainstem, and cerebellum. The diagnosis was confirmed by the demonstration of the rabies antigen from a nuchal skin biopsy and a corneal smear. The patient had a slow but significant recovery over four months and was discharged from the hospital in stable condition with severe neurological sequelae. CONCLUSION We report a unique case of survival after infection with a universally fatal disease.