Age: 19.0
Sex: F
Vaccine: RAB, RAB
Symptoms: Insomnia, Judgement impaired, Liver function test normal, Memory impairment, Metabolic function test normal
Clinical narrative: Initial report received from literature on 29 Oct 2014. The following is the verbatim for the article abstract: We present the case of a 19-year-old who developed psychotic symptoms after exposure to a potentially rabid animal and post-exposure prophylactic treatment. This case serves to remind physicians to fully explore the possibility of a nonpsychiatric origin of de novo psychotic symptoms and provides indirect evidence in favor of the possible involvement of the immune system in the development of psychotic disorders. A 19-year-old female patient had received a first dose RABIES VACCINE (manufacturer- unknown, batch number, route and anatomical site of administration was not reported) on an unspecified date and second dose RABIES VACCINE (manufacturer- unknown, batch number, route and anatomical site of administration was not reported) on an unspecified date. The patient had no other significant medical history and her parents denied any personal or family history of psychiatric illness, suicide or substance use. On an unspecified date after two days following her second shot patient developed difficulties sleeping, reported hearing multiple voices, after four days later of second shot patient's sister called her stating that the patient was anxiously packing up her belongings and repeating "there are demons in the house, I can't stay", patient appeared malnourished and reported no desire to eat or drink and partially healed bite wound on her left calf, psychosis not otherwise specified, Psychosis secondary to general medical condition, such as rabies or rabies vaccine and post-vaccine encephalopathy. It was reported that on patient appeared extremely anxious and confused with simple tasks such as inserting braces for her teeth or putting on eye-glasses and patient memory, attention and concentration were poor, as were insight and judgment, impulse control was intact. On physical examination, patient was spiking a fever of 100.6-100.8 F (38.1-38.2 degree C). On an unspecified date patient was hospitalized. Patient had received a haloperidol 2 mg by mouth mornings and evenings, lorazepam 1 mg by mouth twice/day, and olanzapine 5 mg by mouth evenings, Amoxicillin 875 mg/clavulanate potassium 125 mg by mouth every 12 hours was added to counter any bacterial infection at the origin of the fever and discharged after two weeks patient received olanzapine 5 mg by mouth twice/day and clonazepam 0.5 mg by mouth evenings and quetiapine 100 mg twice/day as a corrective treatment. Laboratory investigations included on an unspecified date Complete blood count, comprehensive metabolic panel, urine toxicology, EKG (Electrocardiogram), urine analysis, urine pregnancy and head CT (computed tomography) scan were all within normal limits. On an unspecified date lab investigations showed increased liver enzymes from the previous PER visit ALT 58-670 U/L, (alanine aminotransferase), AST 114-255U/L (aspartate aminotransferase). At the time of this report, patient outcome was recovered on an unspecified date; however patient was discharged from the hospital on an unknown date. List of documents held by sender: none.