男性,46岁,患者发病前2月狗咬伤右外踝,未注射狂犬疫苗。人院前7天突感两侧腰部胀痛,当夜出现频繁遗精。入院前4天又出现精神紧张,小便时全身抖动,同时伴不规则发热、汗多、尿频尿急,无尿痛。入院当天出现谵妄,无恐水恐风。查体:T40℃,P100次,R21次,BP14/10kPa,谵妄,有时答话切题,恐慌表情,全身抖动,查体不合作。瞳孔等大等圆,约0.4cm×0.4cm,光反射灵敏。颈软,四肢活动正常,右下肢外踝周围有抓伤痕迹。脑膜刺激征阴性。血象、脑脊液及电解质等检查无特殊发现。入院后给予补液、纠酸、镇静等相应处理,病情无好转。入院第三天出现恐水恐 Male, 46 years old, the dog was bitten right lateral malleolus two months before the onset of the disease and rabies vaccine was not injected. 7 days before the hospital sudden surprise on both sides of the waist pain, frequent nocturnal emission that night. Four days before admission, he developed mental stress. When he was urinating, his whole body shook. At the same time, he had irregular fever, sweating, frequent urination, and no dysuria. On the day of admission delirium, fear of fear of winds. Examination: T40 ℃, P100 times, R21 times, BP14 / 10kPa, delirium, and sometimes answer the question, panic expression, body shaking, physical examination is not cooperation. Pupil and other large round, about 0.4cm × 0.4cm, light reflection sensitive. Neck soft, normal limbs, right lower extremity around the lateral malleolar scratch marks. Meningeal irritation sign negative. Blood, cerebrospinal fluid and electrolyte examination found no special. Give rehydration after admission, correct acid, sedation and other appropriate treatment, the condition did not improve. The third day of hospitalization fear of fear of fear