Rabies or a psychiatric disorder? A rare case report

The rabies virus entered the body, the virus moves towards the brain along the nerves. Manifestations of rabies appear after 10 to 50 days from entrance of virus to the body. The first symptoms of the disease in humans include: pain at the bite site, a general feeling of illness, depression, headache, nausea, and vomiting. As the virus begins to proliferation and multiply in the spinal cord or brain, neurological symptoms would appear, including Anxiety, confusion, excessive saliva production, hallucinations, high level of excitement, insomnia, restlessness, paralysis of lower legs, voice box spasms and problems swallowing due to painful throat. Pseudorabies where the person after an animal bite behaves as if he is afflicted with rabies, is well introduced in literature and it is one of differential diagnoses of rabies. A 27 year-old, single male with hypochondriasis, a overvalued idea that he had contracted rabies. The patient failed to respond to multiple somatic therapies and twice made a serious suicide attempt. The patient believed in that he is rabid and attack to persons for biting them and bitted himself. The psychodynamics of the present case is various. Our patient had a painful experience, which was traumatizing to his ego, and this precipitated the conversion symptoms and finally the diagnosis was hypochondriasis plus conversion disorder.