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Rabies

Ashley Twyman, MD and Laura B. Bishop, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

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

  • May present with either encephalitic or...

DIAGNOSIS

In most cases, the diagnosis is clinical based on the history and physical exam. 

HISTORY

  • History of animal exposure; however, most patients do not recall exposure

  • Five stages (may overlap):

    • Inc...

TREATMENT

There is no specific treatment once symptoms have developed. Neither rabies vaccine nor rabies immunoglobulin improve the prognosis. 

GENERAL MEASURES

Thorough wound cleansing with soap and wa...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

After primary vaccination, serologic testing is necessary only if the patient has a severe illness or takes immunosuppressive medication to ensure titers to vacci...

REFERENCES

1
Jackson AC. Rabies. Handb Clin Neurol.  2014;123:601–618.
2
Aramburo A, Willoughby RE, Bollen AW, et al. Failure of the Milwaukee protocol in a child with rabies. Clin Infect Dis.  ...

ADDITIONAL READING

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

  • Crowcroft NS, Thampi N. The prevention and management of rabies. BMJ.  2015;350:g7827.

  • Hemachudha T, Ugolin...

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

  • Caused by an RNA virus Rhabdoviridae; transmitted by infected animal saliva

  • Rabies is a vaccine-preventable virus.

  • Rabies is rare in US; more common in other areas, particularly Africa a...

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