CASE REPORT:
A 52‐year‐old man in OPD presented as hydrophobia allowing us to suspect
human rabies. Past history of dog bite 6 weeks prior with local wound
care immediately after exposure and inadequate1, only
one dose of rabies postexposure vaccine by ID route after bite. He
presented with fever, headache, sore throat, cough, nausea, vomiting,
loss of appetite, excessive salivation with difficulty in swallowing,
insomnia and pain in bitten area.
On examination, feeling confused and restless, more aggressive, muscle
cramps, hyperactive and hyperventilation. During the physical
examination, the patient was conscious and polypnea at 32 bpm and
tachycardia at 110 pulses/min. The body temperature was 40°C, and the
blood pressure was 108/80 mm Hg. He also complained of intense thirst,
but any attempt of water intake caused hydrophobic spasm, described as a
blockage in the throat with worsening of dyspnoea, and he systematically
repelled the glass of water. On blowing of both (later, any ear) ears we
found that the muscle spasms and the aggressiveness along with
hyperactiveness increased tremendously. As this sign was once told by
our Prof. K D GUPTA sir so we have coined it as the “KD EAR BLOW SIGN
IN RABIES”. That patient expired after 2 days and his rabies diagnosis
was confirmed by direct fluorescent antibody test (DFAT) using
post-mortem brain samples.