Dorsolumbar Myelitis Following Antirabies Vaccination with Duck Embryo Vaccine

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Abstract
This is a report of a case of dorso lumbar myelitis which developed as an allergic reaction to duck embryo anti-rabies vaccine. Patient was bitten on the thigh by a stray dog. 6 days later, a course of 14 daily injections of anti-rabies vaccine was begun, using duck-embryo vaccine. On the day of the 13th inoculation he became weak, and had difficulty voiding. On the next day, he developed urinary retention and fever. Within the next two days he developed numbness of both lower extremities, followed by complete flaccid paraplegia, incontinence of bowel and bladder, and anesthesia to the level of the 4th rib bilaterally. The abdominal and cremasteric reflexes, as well as deep tendon reflexes in the lower extremities, were absent. There was bilateral ankle clonus, with questionable Babinski reflexes. These findings persisted for 3 days. On the 4th day of his illness, he was able to rotate the lower extremities, and flex the left knee slightly. Thereafter there was steady improvement, and in the 10th day of his illness, he was able to get into a wheelchair. His improvement continued, and he left the hospital against advice, on the 20th day of his illness. When seen several weeks later, his recovery was complete. This is the first reported instance of a neurologic reaction to the duck-embryo anti-rabies vaccine. Recovery had begun before steroid and antihistamine therapy was started. It is believed, therefore, that this therapy played a minor role in the outcome of the case.

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