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The case being discussed presents a patient who has altered mental status, for whom the initial diagnosis was difficult due to an absent clear bite history and typical symptoms. The final diagnosis of the case was confirmed by metagenomic next\u2010generation sequencing (mNGS) of directly from cerebrospinal fluid, which led to the detection of the rabies virus. This case underscores the critical diagnostic value of mNGS in identifying elusive neurotropic infections.<\/jats:p>","DOI":"10.1002\/vms3.70748","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T14:26:55Z","timestamp":1768919215000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis of Paralytic Rabies by Metagenomics Next\u2010Generation Sequencing: A Case Report and Review of the Literature"],"prefix":"10.1002","volume":"12","author":[{"given":"Lianghai","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine Chengdu Integrated TCM &amp; Western Medicine Hospital  Chengdu Sichuan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine the Second People's Hospital of Yibin, West China Hospital  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