Rabies-like Hysteria Misdiagnosis as Rabies:A Report of Six Cases

ZHOU Jian-li; WANG Bin; XIE Xiang-hong; ZHANG Xiao-fang

doi:10.3969/j.issn.1002-3429.2014.06.014

Abstract：Objective To explore clinical features of rabies-like hysteria and the key points of differential diagnosis. Methods Clinical data of six patients with rabies-like hysteria misdiagnosed as having rabies was retrospectively analyzed. Results All the six patients had been bitten by dogs, and were treated timely and injected with rabies vaccine. After 1-6 months, the patients had the symptoms of fear, consciousness, insomnia, thirst, hydrophobia and throat striction without obvi-ous inducement and symptoms of salivation, dread of wind and fever. Two of them had bucking while drinking along with ex-cessive crying, blushing and distress expressions. Four patients in our hospital and two patients in other hospitals were misdi-agnosed as having rabies, and the rabies-like hysteria was confirmed after history inquiry, negative result of antibody against rabies virus, and the 6 aggressive dogs were healthy and no abnormal appearance was found. The symptoms of throat striction, fear, and hydrophobia were relieved after corresponding and suggestive treatments, and the patients were discharged. Conclu-sion Clinicians should pay attention to the differential diagnosis of rabies-like hysteria and rabies. Epidemiological data col-lection and disease observation should be enhanced, and the diagnosis should be made and combined with positive signs and auxiliary examination results in order to reduce the misdiagnosis rate.