Rabies (dumb)

This form of rabies runs a less dramatic but longer course than the furious form. Patients may have:

• fever
• piloerection and fasciculations
• ascending paralysis or symmetric quadriparesis
  • flaccid muscle weakness is seen in the early onset of infection which starts at the site of the bite or scratch, followed by gradual paralysis
  • maybe misdiagnosed as Guillain-Barré syndrome – distinguished by the presence persistent fever, an intact sensation except at the bite site, myoedema, and bladder dysfunction (1,2)

Diagnosis is difficult due to the absence of cardinal symptoms seen in those with the furious form (1).

This variety of rabies commonly occurs after bites from rabid bats.

Reference:

• (1) Crowcroft NS, Thampi N.The prevention and management of rabies. BMJ. 2015;350:g7827.
• (2) World Health Organization (WHO). Rabies