Rabies With Unusually Long Incubation Period in a Nigerian Male - A Case Report.

Abstract

Background: Rabies is a highly contagious viral infection of the nervous system with a still as yet high mortality rate even in advanced settings. Management maybe enhanced with early presentation. The incubation period usually ranges from 7 days to I year with a mean of 1 - 2 months.
Method: The case report of a 34 year old Nigerian male presenting with clinical rabies is discussed. The onset of the illness comes 112 days after a dog bite. This incubation period is unusual in this environment.
Result: A 34 year old male metal worker of the Igbo tribe and resident in Abakaliki, South East Nigeria was admitted into the medical ward of the University of Nigeria Teaching Hospital Enugu on the 7th of May 2008 with an 8 day history of headache and a 4 day history of involuntary spasms of facial and pharyngeal muscles associated with pain on drinking water. He also complained of fever. He recalled being bitten about mid- January 2008 by the uncle's dog which had earlier bitten another boy. He sought immediate medical assistance in his locality but did not get any help. Hydrophobia was demonstrable and he exhibited episodes of delirium interspersed with lucid intervals and intermittent generalised muscle rigidity. No focal signs were evident. He died as medical therapy was being instituted.
Conclusion: There is a need for the strengthening of public health measures directed at enhancing primary and secondary prevention of rabies in man and animals. This coupled with the prompt presentation of suspected cases and institution of appropriated care may go a long way in reducing the morbidity and mortality rates of rabies in Nigeria.


Keywords: Rabies, unusual presentation, Nigeria.

Journal of College of Medicine Vol. 13 (2) 2008: pp. 123-125