5PSQ-119 Encephalomyelitis after rabies vaccination: a report of two cases

<h3>Background and Importance</h3> Rabies is a deadly viral disease that requires post-exposure vaccination prophylaxis after a suspected animal bite. Although rabies vaccines are generally safe, serious adverse effects can occur. We report two cases of children who developed neurological complications following rabies vaccination. <h3>Aim and Objectives</h3> To present two cases of children who received rabies vaccination after a dog bite and developed serious complications, in order to examine the clinical presentation, investigations, and treatments administered. <h3>Material and Methods</h3> This is an analysis of two notifications from the infectious disease department of our hospital concerning children aged 6 and 10 years who developed complications after receiving post-exposure rabies vaccination. Data were collected from the patients’ medical records, including results from clinical, biological, and radiological examinations. <h3>Results</h3> Two children, aged 6 and 10 years, received rabies vaccination following dog bites. The first child (6 years old) presented with fever, altered consciousness, and a deterioration in general condition after the fourth dose of the vaccine. The second child (10 years-old) developed paralysis and fever after the third dose. Both children were hospitalised, and investigations, including saliva and cerebrospinal fluid (CSF) samples, as well as a brain magnetic resonance imaging (MRI), were conducted. The two children received antibiotic therapy and corticosteroid boluses, with immunoglobulin administered to only one of the children. The diagnosis was established based on MRI findings suggestive of rabies encephalitis, as well as negative results from saliva and CSF samples that excluded the presence of the rabies virus, clearly pointing towards post-vaccination encephalitis. <h3>Conclusion and Relevance</h3> These cases demonstrate that, although rare, serious neurological complications, such as encephalitis, can occur after rabies vaccination. These events highlight the importance of careful post-vaccination monitoring, especially in children, to quickly detect and treat serious adverse effects. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest