Human rabies--Québec, Canada, 2000.

On September 22, 2000, a 9-year-old boy awoke with a fever and complained of pain in his upper left arm. The pain persisted, and he developed insomnia and tremors in his arm and hand. He was admitted to a local hospital on September 27. That evening, he had mild dysphagia, pruritus of his upper chest and back, and a transient macular rash. On September 28, he developed tremors and myoclonic jerks in both arms, had become agitated, and had hydrophobia, aerophobia, dysarthria, and visual hallucinations. The next day hypersalivation was observed and the tremors and myoclonus had spread to his lower extremities. He became very anxious, indicated that he was suffocating, and underwent endotracheal intubation. A diagnosis of rabies was considered and he was transferred to a children's hospital. Laboratory findings were normal except a mildly elevated cerebral spinal fluid protein. An electroencephalogram form indicated no epileptiform activity. Head magnetic resonance imaging was normal. On September 29, the results of the rabies tests were positive, and rabies immune globulin and vaccine were administered to the patient. His neurologic and hemodynamic status deteriorated, and he died on October 6.