Internal Medicine

0521779407-18 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 8:1

Pyridoxine Deficiency Rabies 1259

differential diagnosis

n/a

management

n/a

specific therapy

■correct underlying causes; pyridoxine

Side Effects & Contraindications

■None

follow-up

n/a

complications and prognosis

■Reversible with replacement

RABIES

CAROL A. GLASER, MD

history & physical

History

■RNA virus/Rhabdovirus family

■Large animal reservoir of sylvatic rabies exists in U.S. (includes

skunks, bats, raccoons, foxes)

■Domestic animals occasionally infected by wild animals

■Rodents, rabbits – RARE

■Usually transmitted by bites (less commonly licking of mucosa or

open wounds)

■Transmission has occurred by transplantation of organs

■A small number of “nonbite humans rabies” reported where expo-

sure were in environments containing rabies virus in extremely high

concentration

➣e.g. caves/aerosolized rabies virus from bats

➣e.g. laboratories working with infected tissues

■incubation period dependent upon site of wound (in relation to rich-

ness nerve supply) and distance from brain as well as amount of virus

present