[Progressive human viral encephalitis associated to a bat bite].

INTRODUCTION: Human rabies is a rapidly progressive encephalitis that is transmitted by the bites of an infected mammal.

METHODS: In June 2004, a male patient was admitted to a hospital emergency department after a 5-days history of progressive right arm pain, paresthesias and muscle weakness. He reported contact with a sick bat 5 weeks before admission. He suffered steady neurologic decline with fever, confusion, disorientation, hydrophobia and aerophobia the following day. The patient died two days later.

RESULTS: Postmortem histopathology showed perivascular mononuclear infiltration and extensive neuronolysis. When the fluorescent antibody technique was applied, most residual neurons were infected by the rabies virus. Lyssavirus isolation was achieved in a murine neuroblastoma cell culture. A nested reverse transcription polymerase chain reaction was positive in the patient's cerebrospinal fluid as well as the tissues of the bat Lasionycteris noctivagans.

CONCLUSIONS: Clinicians should suspect rabies when unexplained progressive encephalitis is observed.