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Limbic system symptoms of rabies infection
  1. Ritin Mohindra,
  2. Mohata Madhav,
  3. Vikas Suri and
  4. Krishna Divyashree
  1. Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Krishna Divyashree; divyashreek95{at}


Rabies is a fatal aggressive disease of the nervous system which predominantly causes motor and autonomic dysfunction. Limbic system involvement has been reported rarely, with limited data on its prevalence. The diagnosis becomes challenging when a patient presents with limbic system involvement in the absence of a clear history of an animal bite. We herein illustrate a case of a young man who presented with recurrent episodes of inappropriate ejaculation. He eventually developed hydrophobia and aerophobia, leading to a diagnosis of rabies. This case emphasises the importance of considering the possibility of rabies encephalitis when a patient presents with symptoms of limbic system involvement since early diagnosis helps in instituting appropriate public health measures and reducing exposure to infection. Furthermore, high-quality intensive care with supportive management is the mainstay of therapy in such patients until we have novel and effective antiviral drugs for rabies treatment.

  • Vaccination/immunisation
  • Infection (neurology)
  • Infection control in hospital

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  • Contributors RM, KD and MM were primarily involved in patient management. RM and KD were primarily involved in drafting the manuscript. VS revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.