Rabies physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]
Overview
Common physical examination findings of rabies include hyperpyrexia alternating with hypothermia, tachycardia, respiratory collapse, hypersalivation, lacrimation, sweating, dilatation of the pupils and bradycardia. Skin findings may include percussion myoedema, bite marks and bruises.
Physical Examination
Vital Signs
- Hyperpyrexia alternating with hypothermia
- Tachycardia
- Respiratory and vascular collapse
- Bradycardia
Skin
HEENT
Neck
- No abnormal findings
Lungs
- 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
Abdomen
- Guarding may be present
Genitourinary
- No abnormal findings
Neuromuscular
- 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
- Bite marks
- Muscle atrophy
- Fasciculations in the upper/lower extremity