Patient 2
A 13-year-old boy residing in Aïoun city, southern Mauritania, was referred from Aïoun hospital center on August 19, 2021, for better management of hyperthermia and psychomotor agitation. Past medical history indicated that a stray dog ​​bit the patient on the left cheek and chest three weeks earlier (July 31, 2021). On admission, a scar at the site of the bite, restlessness, intermittent spastic hypertonia, psychomotor agitation, persecutory delirium, fever, hydrophobia, and excessive salivation were observed. These symptoms were reported to occur since 36 hours prior to admission. The diagnosis of rabies encephalitis was retained on the basis of clinical presentation. Symptomatic treatment was administered without success. The results of routine clinical laboratory tests were normal. The patient was discharged against medical advice and died two days later. The investigation around the case made it possible to find an undeclared case in Aïoun but further detailed information was not obtained.