最近审阅: 3 十一月 2020
最近更新: 04 七月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 恐水
  • 恐风
  • 肢体麻木、疼痛、感觉异常
  • 瘙痒
  • 吞咽困难
  • 发热
  • 行为改变
  • 激惹和意识混乱
  • 幻觉
  • 自主神经功能紊乱的体征
  • 病情快速进展
  • 无力和麻痹

其他诊断因素

  • 大小便失禁
  • 昏迷
  • 腹痛
  • 失眠
  • 惊厥
  • 发音含糊、口齿不清
  • 共济失调

危险因素

  • 最近被已知感染宿主抓伤或咬伤
  • 前往/居住于狂犬病流行国家
  • 职业或娱乐休闲暴露
  • 年龄 <15 岁

诊断性检查

首要检查

  • 唾液PCR检查和病毒培养
  • 皮肤活检(颈部)检测直接荧光抗体(DFA)和聚合酶链反应
  • 脑脊液细胞学
  • 脑脊液生化
  • CSF狂犬病病毒中和抗体
  • 狂犬病血清IgM或IgG抗体
  • 脑脊液单纯疱疹病毒PCR检查
  • 脑脊液肠病毒PCR检测
  • 脑脊液西尼罗河病毒 IgM
  • 血清N-甲基-D-天门冬氨酸(NMDA)谷氨酸受体抗体
更多 首要检查

需考虑的检查

  • 血清虫媒病毒抗体
  • 血清巴尔通氏体属抗体
  • 血清立克次氏体抗体
  • 头部 MRI
更多 需考虑的检查

治疗流程

撰稿人

General Director

National Center for Public Health

National Health Institute

Lima

Peru

利益声明

SR declares that he has no competing interests.

Professor

Pediatrics

Medical College of Wisconsin

Milwaukee

WI

利益声明

The Medical College of Wisconsin receives funds for research grants related to rabies. RW provides advice to teams treating human rabies and is an author of a number of references cited in this monograph.

Dr Sergio Recuenco and Dr Rodney Willoughby would like to gratefully acknowledge Dr Kis Robertson, a previous contributor to this monograph. KR declares that she has no competing interests.

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Head

School of Public Health

Tropical Medicine and Rehabilitation Sciences

Faculty of Medicine

Health and Molecular Sciences

James Cook University

Townsville

Queensland

Australia

利益声明

PL is a member of the Australian Travel Health Advisory Group that is supported by a grant from GlaxoSmithKline. PL has received travel grants from GlaxoSmithKline to attend travel medical conferences in the last 5 years.

Assistant Professor

Department of Family and Community Medicine

Dalla Lana School of Public Health

University of Toronto

Toronto

Ontario

Canada

利益声明

AG declares that he has no competing interests.

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