Rafa Aidya Saraswati
Introduction Rabies is a zoonotic viral infection disease targeting CNS. This disease is mortal, 99% of the patients diagnosed end up die, transmitted from rabid animal hosts, mostly dogs. Globally, it has its own endemic areas, including Indonesia, of 34 provinces, 24 had reported rabies case. Until now, there is no cure for the disease, it can only be prevented by vaccine injection. Theoritically, the incubation period range from 20-90 days. In this case, it was 1 year, proven virus can be differ in behavior (reproduction and travel time). Case Descriptions On September 2017, 51 years old woman was referred from primary healthcare as brought by her husband complaining of change in his wife’s behavior. She was tend to be agitated and uncooperative. In the ambulance, she was fidgety when the wind touched her skin. Turning out she had history of unknown dog’s bite one year prior and didn’t seek for any vaccine injection. From anamnesis and physical examination: she was alert although seen restless. Every word she said were still in the right sense and in accordance with the questions. Her vital sign was stable with positive results on aerophobic and hydrophobic test. Other physical and neurological examination showed no abnormalities. Twelve hours after, the patient didn’t survive. Discussion Several differential diagnoses can be considered with chief complaint of agitation: metabolic, neurological, psychological, and infectious disease. Patient history of rabid dog’s bite without vaccine injection still made uncertain rabies diagnosis because of a long-time incubation period. For every examination and supportive test possible showed no tendency on other DD, specific aerophobic and hydrophobic test were performed with positive results. This case had proven one-year-post-viral transmission can be resulted to rabies. Conclusion Needs further investigation, how can the virus be varied in incubation period and if there is any specific factors underlie the condition.