(#8) Delusion, Paranoia, and Rabies: The Psychiatric Complexity of a Case of Rabies Hysteria

Abstract: Rabies hysteria, though historically documented, remains an underrecognized psychiatric manifestation in modern medicine. This poster presents a striking case of a 63-year-old PhD scientist who developed delusions following post-exposure prophylaxis (PEP) for a potential rabies exposure. Despite negative tests and multiple medical reassurances, the patient exhibited persistent belief that a rabies vaccine dose was intentionally contaminated. Over 15 months, he contacted hundreds of providers and underwent extensive, costly diagnostics at 13 hospitals, including 23 visits and repeated rabies antibody testing. His presentation included paranoid delusions, somatic complaints, and functional impairment. A trial of antipsychotic therapy was only intermittently effective; his delusions eventually shifted to concerns about radiation poisoning from imaging studies. This case illustrates how rabies hysteria intersects with delusional disorder and conversion disorder, resulting in significant overutilization of healthcare resources. We discuss diagnostic challenges, the importance of interdisciplinary psychiatric care, and strategies for setting limits and engaging appropriate support systems. The case underscores how fear surrounding a rare and fatal disease like rabies can amplify psychiatric symptoms, even in highly educated individuals, and why early psychiatric recognition is crucial for appropriate management and healthcare stewardship.

Short Description: A case study exploring the psychiatric presentation of "rabies hysteria" in a scientist convinced his vaccine was deliberately contaminated. The poster highlights diagnostic complexity, delusional evolution, and the importance of psychiatric intervention in preventing healthcare overuse.

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