Rabies physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview[edit | edit source]

Common physical examination findings of rabies include

Physical Examination[edit | edit source]

Vital Signs[edit | edit source]

• Hyperpyrexia alternating with hypothermia
• Tachycardia 
• Respiratory and vascular collapse
• Bradycardia

Skin[edit | edit source]

• Percussion myoedema (mounding of the muscle at the percussion site)
• Bite marks
• Bruises

HEENT[edit | edit source]

• Hypersalivation
• Lacrimation
• Sweating
• Dilatation of the pupils

Neck[edit | edit source]

• Normal

Lungs[edit | edit source]

• Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally, if aspirated.
• Wheezing may be present due to aspiration or chest infection
• Normal/reduced tactile fremitus

Heart[edit | edit source]

• S1 normal, soft
• S2 normal

Abdomen[edit | edit source]

• Guarding may be present

Genitourinary[edit | edit source]

• No abnormal findings

Neuromuscular[edit | edit source]

• Opisthotonos
• Altered mental status
• Increased tendon reflexes with extensor plantar responses
• Flaccid paralysis with generalized areflexia when patient develops coma
• Nuchal rigidity
• Increased muscle tone
• Fasciculations

Extremities[edit | edit source]

• Bite marks
• Muscle atrophy
• Fasciculations in the upper/lower extremity

References[edit | edit source]

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