Rabies - Revision history

Dx: /* Animal was captured */

2025-02-04T10:00:59Z

Animal was captured

← Older revision		Revision as of 10:00, 4 February 2025
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	=====Animal was captured=====		=====Animal was captured=====
	''Is animal dog or cat?''		''Is animal dog or cat?''
	*Yes: Observe 10 days, if abnormal, euthanize and treat patient with the vaccine and RIG. ~~Then patient treatment~~ can be discontinued if the animal pathology is negative for rabies		*Yes: Observe 10 days, if abnormal, euthanize animal and treat patient with the vaccine and RIG. Treatment can be discontinued if the animal pathology is negative for rabies
	*No: Euthanize animal and treat patient with vaccine and RIG. Discontinue if animal pathology is negative for rabies		*No: Euthanize animal and treat patient with vaccine and RIG. Discontinue if animal pathology is negative for rabies

2021-04-04T15:47:47Z

Immunocompetent + NOT Vaccinated

← Older revision		Revision as of 15:47, 4 April 2021
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	**20 IU/kg subcutaneous		**20 IU/kg subcutaneous
	**Infiltrate around wound if possible		**Infiltrate around wound if possible
	**~~place~~ remainder opposite arm of vaccine		**Place remainder opposite arm of vaccine
	**~~can~~ administer up to 7 days after the first vaccine dose		**Can administer up to 7 days after the first vaccine dose

	====Immunocompetent + Vaccinated====		====Immunocompetent + Vaccinated====

2021-03-25T16:01:05Z

Clinical Features

← Older revision		Revision as of 16:01, 25 March 2021
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	==Clinical Features==		==Clinical Features==
			[[File:Manwithrabies4.png\|thumb\|Man with rabies.]]
	''Clinical rabies is incredibly rare.''		''Clinical rabies is incredibly rare.''
	*Incubation period = ~20-90 days, but may be shorter or longer		*Incubation period = ~20-90 days, but may be shorter or longer

2021-03-24T14:44:34Z

Animal was not captured

← Older revision		Revision as of 14:44, 24 March 2021
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	=====Animal was not captured=====		=====Animal was not captured=====
	''Is ~~Animal~~ dog or cat?''		''Is animal dog or cat?''
	*Yes: Give ~~vacc~~ and RIG only if rabies risk for species in area		*Yes: Give vaccine and RIG only if rabies risk for species in area
	*No: Treat with full course ~~vacc~~ and RIG		*No: Treat with full course vaccine and RIG

	==Management==		==Management==

2021-03-24T14:43:57Z

Animal was captured

← Older revision		Revision as of 14:43, 24 March 2021
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	=====Animal was captured=====		=====Animal was captured=====
	''Is animal dog or cat?''		''Is animal dog or cat?''
	*Yes: Observe 10 days, if abnormal, ~~sacrifice~~ and treat patient with the ~~vacc~~ and RIG. Then patient treatment can be discontinued if the animal pathology is negative for rabies		*Yes: Observe 10 days, if abnormal, euthanize and treat patient with the vaccine and RIG. Then patient treatment can be discontinued if the animal pathology is negative for rabies
	*No: ~~Sacrifice~~ animal and ~~begin~~ RIG ~~and vaccine~~. Discontinue if animal negative ~~path~~ for rabies		*No: Euthanize animal and treat patient with vaccine and RIG. Discontinue if animal pathology is negative for rabies

	=====Animal was not captured=====		=====Animal was not captured=====
	''Is Animal dog or cat?''		''Is Animal dog or cat?''

2021-01-15T19:35:48Z

Paralytic form

← Older revision		Revision as of 19:35, 15 January 2021
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	*Paresis in bitten extremity → quadriparesis, bilateral facial weakness → coma, organ failure		*Paresis in bitten extremity → quadriparesis, bilateral facial weakness → coma, organ failure
	*Hydrophobia (50%) --> spasms of larynx, pharynx, diaphragm		*Hydrophobia (50%) --> spasms of larynx, pharynx, diaphragm
			*Aerophobia (9%) --> spasms of larynx, pharynx, diaphragm in response to drafts of air (pathognomonic)<ref>Petersen BW, Rupprecht CE. Human Rabies Epidemiology and Diagnosis. US Centers for Disease Control and Prevention, 2011. https://www.intechopen.com/books/non-flavivirus-encephalitis/human-rabies-epidemiology-and-diagnosis (Accessed on January 15, 2021).</ref>
	*Death from various complications: pituitary complications, respiratory dysfunction, cardiac dysfunction, autonomic dysfunction.		*Death from various complications: pituitary complications, respiratory dysfunction, cardiac dysfunction, autonomic dysfunction.

2018-10-20T22:13:04Z

← Older revision		Revision as of 22:13, 20 October 2018
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	==Disposition==		==Disposition==
			*Patient needing prophylaxis: outpatient
			*Clinical rabies: admit

	==See Also==		==See Also==

2018-10-20T22:09:03Z

Management

← Older revision		Revision as of 22:09, 20 October 2018
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	==Management==		==Management==
	===Immunocompetent + NOT Vaccinated===		===Prophylaxis===
			====Immunocompetent + NOT Vaccinated====
	*Clean the wound (e.g. copious irrigation)		*Clean the wound (e.g. copious irrigation)
	*Rabies vaccine (human diploid cell vaccine)		*Rabies vaccine (human diploid cell vaccine)
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	**can administer up to 7 days after the first vaccine dose		**can administer up to 7 days after the first vaccine dose

	===Immunocompetent + Vaccinated===		====Immunocompetent + Vaccinated====
	*Clean the wound (e.g. copious irrigation)		*Clean the wound (e.g. copious irrigation)
	*Rabies vaccine (human diploid cell vaccine)		*Rabies vaccine (human diploid cell vaccine)
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	*NO rabies immune globulin		*NO rabies immune globulin

	===Immuno-compromised===		====Immuno-compromised====
	*Clean the wound (e.g. copious irrigation)		*Clean the wound (e.g. copious irrigation)
	*Rabies vaccine (human diploid cell vaccine)		*Rabies vaccine (human diploid cell vaccine)

2018-10-20T22:07:14Z

Background

← Older revision		Revision as of 22:07, 20 October 2018
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	==Background==		==Background==
	*Indication for ~~Prophylaxis~~		*Almost always fatal (diagnosis frequently made postmortem)
			*Indication for prophylaxis:
	**Bite or salivary exposure from bat, or mammalian carnivore		**Bite or salivary exposure from bat, or mammalian carnivore
	**Close proximity with unknown salivary exposure (e.g. live/dead bat in room)		**Close proximity with unknown salivary exposure (e.g. live/dead bat in room)

2018-10-20T22:06:49Z

Clinical Features

← Older revision		Revision as of 22:06, 20 October 2018
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	==Clinical Features==		==Clinical Features==
	Clinical rabies is incredibly rare.~~<br />~~		''Clinical rabies is incredibly rare.''
	~~Almost always fatal. Diagnosis frequently made postmortem.<br />~~		*Incubation period = ~20-90 days, but may be shorter or longer
	Incubation period ~20-90 days, but may be shorter or longer.

	~~'''~~Encephalitic form~~:''' hyperexcitability~~, disorientation, bizarre behavior, hallucinations~~, autonomic~~ dysfunction (~~eg,~~ hypersalivation)~~<br />~~		===Encephalitic form===
	~~'''~~Paralytic form~~:''' paresis~~ in bitten extremity → quadriparesis, bilateral facial weakness → coma, organ failure~~<br />~~		*Hyperexcitability, disorientation, bizarre behavior, [[hallucinations]]
	50% ~~of patients may have hydrophobia~~ --> spasms of larynx, pharynx, diaphragm~~<br />~~		*Autonomic dysfunction (e.g. hypersalivation)
	Death from various ~~complications—eg,~~ pituitary complications, respiratory dysfunction, cardiac dysfunction, ~~autononmic~~ dysfunction.
			===Paralytic form===
			*Paresis in bitten extremity → quadriparesis, bilateral facial weakness → coma, organ failure
			*Hydrophobia (50%) --> spasms of larynx, pharynx, diaphragm
			*Death from various complications: pituitary complications, respiratory dysfunction, cardiac dysfunction, autonomic dysfunction.

	==Differential Diagnosis==		==Differential Diagnosis==