RABIES PATOPHYSIOLOGY

Rabies virus

Incubation period
Entry into break in skin
(4 days 2 years)
(bites, abrasions, mucosa)

Pain
Fever
INV A SION Headache
PHA SE Malaise
Imminent thoraco- Sore throat
lumbar involvement Anorexia
(PNS): Pupillary Increased sensitivity
dilation, lacrimation,
increased thick saliva
production / foaming
of mouth, excessive
perspiration EX CITEM ENT
Anxiety & fear PHA SE Gradual weakness of muscle groups: muscle
Hydrophobia spasms cease, ocular palsy, vertigo, facial &
Pronounced muscular masseter palsy, weakness of muscles of
stimulation & general phonation, loss of tendon reflexes, neck stiffness
tremor (+)Babinski [lesions at pyramidal tract], (-)
Mania & Kernigs, (-) Brudzinskis
hallucinations with HR shifting from tachycardia (100-120) to
lucid intervals bradycardia (40-60)
Convulsions Cheyne-Stokes respiration
Local sensation diminshed (pain, heat, cold)
PA RA LYTIC Incoordination
PHA SE General arousal
( DEPRESSION PHASE) Bladder & intestinal retention (damage to the
innervation of the musculature of intestine &
bladder)
Hydrophobia disappear but with slight difficulty
swallowing
in some cases, patient shows period of recovery,
this apparent remission is followed by rapid
progressive paralysis
Ascending paralysis,flaccid paralysis of
coma extremities until it reaches the respiratory muscle
Apathy, stupor

Death