Hello! I currently am in microbiology and I am just stumped on a diagnosis, and I have spent hours upon hours trying to make some points match to come up with the diagnosis and I am just coming up blank. So, I was hoping someone could help shed some light on this disease.
The patient complained from insomnia, anxiety, confusion
The patient was having difficulty swallowing.
The doctor reported that the patient had partial paralysis.
The doctor reported that the patient was very agitated and the speech was incoherent.
We received a laboratory report indicating several immunological tests have been performed on samples of saliva, serum, spinal fluid, and skin biopsies of hair follicles at the nape of the neck. The results of the serum and spinal fluid tests indicated the presence of antibodies to a specific virus.
The doctor also requested a skin biopsy for a specific antigen.
The results of the saliva test performed using a reverse transcription followed by polymerase chain reaction have indicated the presence of a virus.
So, after researching all of these tests and having positive viral results, I was thinking Rabies. There were also pictures of perivascular cuffing and a positive dFA test.
Then.....on Monday this bit of information was added: The patient is now beginning to show progressive symptoms, where there is incessant coughing and paroxysm of the symptoms. As the patient coughs it is followed by a whooping sound.
That last bit seems obvious for Pertussis, but I cannot find a link of paroxysms of cough with "whooping" associated with Rabies or a viral infection.
I have thought of a dual diagnosis, but I am just not sure.