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Infect Dis Clin North Am. 2015 Dec;29(4):637-50. doi: 10.1016/j.idc.2015.07.006. Epub 2015 Sep 16.

Rabies: Rare Human Infection - Common Questions.

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Pediatric Infectious Diseases, Children's Hospital of Wisconsin, C450, PO Box 1997, Milwaukee, WI 53201-1997, USA. Electronic address:


Rabies is an acute, rapidly progressive encephalitis that is almost always fatal. Prophylaxis is highly effective but economics limits disease control. The mechanism of death from rabies is unclear. It is poorly cytopathic and poorly inflammatory. Rabies behaves like an acquired metabolic disorder. There may be a continuum of disease severity. History of animal bite is rare. The diagnosis is often missed. Intermittent encephalopathy, dysphagia, hydrophobia and aerophobia, and focal paresthesias or myoclonic jerks suggest rabies. Laboratory diagnosis is cumbersome but sensitive. Treatment is controversial but survivors are increasingly reported, with good outcomes in 4 of 8 survivors.


Biopterin; Brain diseases; Diagnosis; Encephalitis; Lyssavirus; Mortality; Rabies; Therapy

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