Abstract
Kuduz halen ülkemizde endemik olan önemli bir sağlık problemidir. Dokuz yaşındaki erkek hasta bilinç kaybı, solunum yetmezliği ve hipersalivasyon nedeni ile başvurdu. Hikayesinden hastanın yaklaşık bir hafta önce sol göz kapağından bir tilki tarafından ısırıldığı öğrenildi. Aynı gün kuduz aşısı ve immünglobulini uygulanan hastanın fizik muayenesinde ateşi 400C, kalp tepe atımı 160/dk, solunum hızı 20/dk, GKS 6 ve hipersalivasyonu mevcuttu. Ek olarak sol göz kapağında 3x4 cm çaplı sütüre lezyonu mevcut olan hastanın diğer sistem muayeneleri normal olarak değerlendirildi. Kuduz tanısına yönelik gönderilen serum, BOS, salya ve ense saç folikülü örneklerinden sadece ense saç folikülünde kuduz virüsüne ait viral RNA tespit edildi. Çocuk yoğun bakım ünitesinde takip edilen hasta yapılan tüm tedavilere rağmen genel durumu kötüleşerek kardiyorespiratuvar yetmezlik nedeni ile yatışının 5. gününde kaybedildi. Bu olgu vahşi hayvanlarla temas sonucu evcil hayvanlara geçerek büyük bir risk oluşturabilecek kuduz virüsünün tam eradikasyonunun sağlanması için vahşi hayvanlara da yönelik etkin immünizasyon programlarının tekrar gözden geçirilmesi gerektiğini vurgulamak amacıyla sunulmuştur.
References
- Büke M, Büke AÇ. Kuduz. In: Topçu AW, Söyletir G, Doğanay M (ed). İnfeksiyon Hastalıkları ve Mikrobiyolojisi. 2nd ed. Cilt 1. İstanbul: Nobel Tıp Kitabevleri, 2002:1029-41.
- Willoughby RE. Rabies virus. In: Long SS, Pickering LK, Prober CG (eds). Pediatric Infectious Disease. 3rd ed. Philadelphia: Churcill Livingstone, 2008: 1126-30.
- Ahmad R, Orakzai S. Rabies and vaccination failure: Two case report. Pak J Med Sci 2002;4:325-27.
- Depani SJ, Kennedy N, Mallewa M, Molyneux EM. Case report: Evidence of rise in rabies cases in Southern Malawi-better preventative measures are urgently required. Malawi Med J 2012:24:61-4.
- www.who-rabies-bulletin.org/Queries/Surveillance.aspx (02.01.2016).
- Koruk TS, Ün H ,Gürsoy B, Ünal N, Çalışır C, Unutmaz G, ve ark. Yaşarken tanı alan bir insan kuduz olgusu. Mikrobiyol Bul 2010:44:304-9.
- http://www.tkhk.gov.tr/1949_-kuduz-saha-rehberi (05.1.2016).
- Tillotson JR, Axelrod D, Lyman DO. Rabies in a laboratory worker - New York. MMWR Morb Mortal Wkly Rep 1977; 26: 249-50.
- Alvarez L, Fajardo R, Lopez E, Pedroza R, Hemachudha T, Kamolvarin N,et al. Partial recovery from rabies in a nine-year-old boy. Pediatr Infect Dis J 1994; 13: 1154-5.
- Willoughby RE Jr, Tieves KS, Hoffman GM, Ghanayem NS, Amlie- Lefond CM, Schwabe MJ, et al. Survival after treatment of rabies with induction of coma. N England J Med 2005;352:2508-14. 2003;36:60-3.
- Jackson AC. Current and future approaches to the therapy of human rabies. Antiviral Research 2013;99:61-7.
Abstract
Rabies is still an endemic public health problem in Turkey. A 9-year-old boy presented with fever, impaired consciousness, respiratory failure and hypersalivation. He had been bitten by a fox on the left eyelid one week ago. Rabies vaccine and hyperimmunoglobulin treatment were administered on the same day as the incident. Physical examination revealed hypersalivation, fever of 40 oC, heart rate 160 /min, respiratory rate 20/min and GCS of 6. There was also a sutured lesion 3x4 cm in diameter on the left eyelid because of the fox bite. Other system findings were normal. Serum, CSF, saliva and neck hair follicle samples were sent for the diagnosis of rabies but only scruff hair follicle impression smear was positive. The child was treated at the pediatric intensive care unit with supportive measures. His general condition deteriorated and he died due to cardiorespiratory failure and rabies encephalomyelitis on the 5th day. This case was presented to emphasize the need of a program that aims for complete eradication of the virus by active immunization of wild animals that may have contact with human and pets
References
- Büke M, Büke AÇ. Kuduz. In: Topçu AW, Söyletir G, Doğanay M (ed). İnfeksiyon Hastalıkları ve Mikrobiyolojisi. 2nd ed. Cilt 1. İstanbul: Nobel Tıp Kitabevleri, 2002:1029-41.
- Willoughby RE. Rabies virus. In: Long SS, Pickering LK, Prober CG (eds). Pediatric Infectious Disease. 3rd ed. Philadelphia: Churcill Livingstone, 2008: 1126-30.
- Ahmad R, Orakzai S. Rabies and vaccination failure: Two case report. Pak J Med Sci 2002;4:325-27.
- Depani SJ, Kennedy N, Mallewa M, Molyneux EM. Case report: Evidence of rise in rabies cases in Southern Malawi-better preventative measures are urgently required. Malawi Med J 2012:24:61-4.
- www.who-rabies-bulletin.org/Queries/Surveillance.aspx (02.01.2016).
- Koruk TS, Ün H ,Gürsoy B, Ünal N, Çalışır C, Unutmaz G, ve ark. Yaşarken tanı alan bir insan kuduz olgusu. Mikrobiyol Bul 2010:44:304-9.
- http://www.tkhk.gov.tr/1949_-kuduz-saha-rehberi (05.1.2016).
- Tillotson JR, Axelrod D, Lyman DO. Rabies in a laboratory worker - New York. MMWR Morb Mortal Wkly Rep 1977; 26: 249-50.
- Alvarez L, Fajardo R, Lopez E, Pedroza R, Hemachudha T, Kamolvarin N,et al. Partial recovery from rabies in a nine-year-old boy. Pediatr Infect Dis J 1994; 13: 1154-5.
- Willoughby RE Jr, Tieves KS, Hoffman GM, Ghanayem NS, Amlie- Lefond CM, Schwabe MJ, et al. Survival after treatment of rabies with induction of coma. N England J Med 2005;352:2508-14. 2003;36:60-3.
- Jackson AC. Current and future approaches to the therapy of human rabies. Antiviral Research 2013;99:61-7.
Details
| Other ID | JA36UY62FT |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2017 |
| Submission Date | June 1, 2017 |
| Published in Issue | Year 2017 Volume: 11 Issue: 2 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.