Record number: 
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
3 weeks
Alerting signals, symptoms, evidence of occurrence: 
Agitation, delirium, seizures, fever; rapid neurological deterioration.
Demonstration of imputability or root cause: 
Antemortem cerebrospinal fluid analysis for 3 of the 4 recipients was consistent with a viral etiology. Neuroimaging and electroencephalogram studies were suggestive of an infectious encephalitis or a toxic encephalopathy. Initial laboratory testing did not demonstrate an infectious etiology. Postmortem histologic analysis, immunohistochemistry, electron microscopy, and direct fluorescence antibody testing revealed rabies virus infection. Serological testing done postmortem confirmed rabies virus infection in the common donor.
Imputability grade: 
3 Definite/Certain/Proven
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