A RARE CASE OF RABIES INDUCED ENCEPHALITIS OR VACCINE INDUCED GUILLAIN BARRE SYNDROME – A CASE REPORT

Dr. Akansha Singh, Dr. Eva Sharma* and Dr. Cliffin Mathai Kattoor

ABSTRACT

Guillain–Barre syndrome is a rare but fatal autoimmune disease. The most common known etiology of Guillain–Barre syndrome is infectious disease notably caused by Campylobacter jejuni. A very small fraction of people can develop vaccine induced Guillain- Barre Syndrome due to vaccinations like a meningococcal vaccine, poliovirus vaccine, influenza vaccine, and rabies vaccine. Amongst these vaccines, rabies is invariably fatal. However, it can be preventable by early diagnosis and treatment according to the WHO guidelines. Older formulations of rabies vaccines are cultured in the neural tissues and have been found to be associated with an increased risk of Guillain–Barre syndrome. Most of the cases of Guillain–Barre syndrome due to vaccination are either undiagnosed or misdiagnosed. Here, we report a case of vaccine-associated Guillain–Barre syndrome which developed 4 weeks after anti-rabies vaccine which was given after a dog bite in a 39 year old female who presented with lower limb weakness and difficulty in swallowing creating a diagnostic dilemma as a case of paralytic rabies or vaccine induced GBS.

Keywords: Rabies vaccination, Guillain Barre Syndrome, Campylobacter jejuni, Paralytic rabies.