Acute Respiratory Distress Syndrome Secondary to Rabies: A Case Report and Review of the Literature

Abstract

Introduction: Introduction: Rabies is a zoonotic viral infection with a worldwide distribution, primarily found in Asia and Africa, leading to an annual mortality rate of approximately 60 000 cases. The rabies virus is an RNA virus primarily transmitted through mucosal surfaces or contact with compromised skin. In this study, we present a case of rabies associated with acute respiratory distress syndrome (ARDS). Case Presentation: A 64-year-old male who had been bitten by a dog three weeks prior to admission presented to our emergency department with restlessness. A lung CT scan revealed nearly complete opacification of both lungs, indicative of ARDS. Unfortunately, the patient passed away within 5 hours of admission. An autopsy was conducted, and brain samples tested positive for rabies using the direct fluorescent antibody technique. Conclusions: ARDS is a rare but fatal extra-neural complication of rabies, potentially linked to cytokine storms and nitric oxide as etiological factors. Nevertheless, further investigations are warranted to gain a more precise understanding of the pathogenesis.