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 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[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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