A 2½-year-old boy was severely bitten April 1 1969, by a rabid bobcat in San Diego, Calif. He was promptly treated with duck embryo rabies vaccination but not with rabies antiserum. Clinical rabies developed April 18, but with intensive hospital care he survived 133 days after onset of symptoms. Virus could not be isolated from stool, throat, urine, cerebrospinal fluid, saliva, brain biopsy tissue, or from autopsy tissues, probably due to neutralization of virus by antibody, but the diagnosis of rabies was proven by the extremely high rise in rabies antibody titer and by fluorescent antibody staining of brain biopsy tissue. Optimal rabies preventive treatment should be given to all exposed individuals, but if clinical rabies develops, intensive supportive treatment should be given, since survival of at least some cases may be possible. Careful virologic and serologic studies, undertaken as early as possible, are especially important to differentiate rabies from rabies vaccine reaction, and to fully document recovery from rabies should this occur.

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