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Rabies

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A rapidly progressive CNS infection caused by a ribonucleic acid (RNA) rhabdovirus affecting mammals, including humans

  • Generally considered to be 100% fatal once symptoms develop

  • Syste...

DIAGNOSIS

HISTORY

  • History of animal exposure

  • Most patients do not recall exposure.

  • Five stages (may overlap)

    • Incubation period: time between bite and first symptoms: usually 10 days to 1 year (average o...

TREATMENT

Thorough wound cleansing with soap and water is first line of treatment. Irrigate wound with virucidal agent, such as povidone-iodine, if available. 

GENERAL MEASURES

  • Evaluate risk based on ex...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

After primary vaccination, serologic testing is necessary only if the patient has a disease or takes immunosuppressive medication. 

PATIENT EDUCATION

Use screens ov...

REFERENCES

1
Willoughby REJr, Tieves KS, Hoffman GM, et al. Survival after treatment of rabies with induction of coma. N Engl J Med.  2005;352(24):2508–2514. [View Abstract on OvidMedline]
2
Ruppre...

ADDITIONAL READING

  • Centers for Disease Control and Prevention: http://www.cdc.gov/rabies/

  • Centers for Disease Control and Prevention. Recovery of a patient from clinical rabies—California, 2011. MMWR M...

SEE ALSO

Bites, Animal and Human 

CODES

ICD10

  • A82.9 Rabies, unspecified

  • Z20.3 Contact with and (suspected) exposure to rabies

ICD9

  • 071 Rabies

  • V01.5 Contact with or exposure to rabies

SNOMED

14168008 Rabies (disorder) 

CLINICAL PEARLS

  • Rabies is rare in the United States but more common in other areas of the world.

  • Seek immediate treatment if exposed to scratch, bite, or saliva of potentially infected animal (e.g., fe...

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