Images in Clinical Medicine
Kim Eagle, M.D., Editor
Rabies
N Engl J Med 1996; 335:568August 22, 1996
- Article
Figure 1 Three large Negri bodies, which are eosinophilic viral inclusion bodies, can be seen in the cytoplasm of a cerebellar Purkinje cell obtained at autopsy from an eight-year-old boy in Mexico City (hematoxylin and eosin, ×2300). These viral inclusions are the pathological hallmark of rabies. The boy, bitten on the forearm by a dog that died of rabies 15 days later, had numbness and tingling at the site of the bite several days later. He presented at a clinic one month after the bite, and rabies vaccination with Fuenzalida vaccine (suckling-mouse-brain vaccine) was initiated. Two days later he was admitted to the hospital with agitation, aggressive behavior, and hydrophobia. He was treated with sedation, antiepileptic therapy, immune globulin, and ribavirin. His condition progressively deteriorated, and he died 10 days after admission. In the United States, recommendations for postexposure rabies prophylaxis include prompt local cleaning of the wound with soap and water, administration of human rabies immune globulin by infiltration about the wound and intramuscularly (gluteal region), and initiation of a course of rabies vaccination with human diploid-cell vaccine or rhesus-monkey diploid-cell vaccine (rabies vaccine, adsorbed).
Kim Eagle, M.D.
Alan C. Jackson, M.D.
Queen's University, Kingston, ON K7L 3J7, CanadaEduardo Lopez-Corella, M.D., Ph.D.
Instituto Nacional de Pediatria, 04530 Mexico DF, Mexico
