Myocarditis Associated with Rabies

Ross, Eugene; Armentrout, Steven A.

doi:10.1056/nejm196205242662105

Cited by 56 publications

(15 citation statements)

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“…The myocardial damage in dog 2 (given Lagos bat virus, intracerebrally) is of interest, since myocardial lesions have been seen in a few cases of fatal rabies in man [21]. The myocardial damage in this dog may have been caused entirely by the vascular damage, with subsequent interstitial edema and hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Experimental Infection of Dogs and Monkeys with Two Rabies Serogroup Viruses, Lagos Bat and Mokola (IbAn 27377). Gross Pathologic and Histopathologic Changes

et al. 1973

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Abstract. Dogs and monkeys were inoculated intracerebrally or intramuscularly with Lagos bat virus or Mokola virus, two viruses serologically and morphologically related to rabies virus. All animals inoculated intracerebrally died, but some animals inoculated intramuscularly survived. One monkey inoculated intramuscularly with Lagos bat virus survived with a hemiparesis. In both dogs and monkeys that died there was a nons uppurative meningoencephalomyelitis and ganglionitis. Lesions were more extensive than those reported after infection with street rabies virus. Intracytoplasmic inclusions, morphologically indistinguishable from Negri bodies, were seen in the central nervous system of monkeys, but not dogs, that died. With fluorescent-antibody microscopy, granular aggregations of viral antigen were observed in the cytoplasm of many neurons in the central nervous system. In some animals, the retina and ciliary body of the eye had focal inflammatory changes.Recent studies [25,26] have shown that two African viruses, Lagos bat [3] and Mokola (IbAn 27377) [10], are serologically as well as morphologically related to rabies virus, and on this basis the three agents are considered to represent a subgrouping within the rhabdoviruses [25].To obtain data for comparing the two African viruses with street rabies virus in terms of pathogenicity and type of disease response induced, dogs and monkeys were experimentally infected with Lagos bat and Mokola viruses. Clinical, serologic, virologic, and fluorescent-antibody studies of these animals are reported by TIGNOR et al. [27]. This paper reports gross pathologic and histopathologic changes in 14 of the animals. Materials and MethodsThe overall study involved nine purebred beagles, each about 3 months old, and 16 Rhesus monkeys al I at least 5 years old. The animals were kept in individual cages.

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Section: Discussionmentioning

confidence: 99%

Experimental Infection of Dogs and Monkeys with Two Rabies Serogroup Viruses, Lagos Bat and Mokola (IbAn 27377). Gross Pathologic and Histopathologic Changes

et al. 1973

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“…There is infection involving cardiac ganglia and in the myocardium, 10 and, in some cases, there may be a myocarditis with clinical manifestations. [11][12][13][14] A skin biopsy is a useful antemortem diagnostic test in humans because the rabies virus antigen may be detected in nerves adjacent to hair follicles, 15,16 and/or the rabies virus RNA may be detected in the skin biopsy specimen using reverse transcriptionpolymerase chain reaction (RT-PCR) amplification. 17 The most detailed studies of events that take place during the incubation period in a natural model of rabies were performed by Charlton et al 18 in a skunk model.…”

Section: Overview Of Rabies Pathology and Pathogenesismentioning

confidence: 99%

“…72,74 The cardiac manifestations probably reflect infection involving the autonomic nervous system (eg, cardiac ganglia) or myocardium, 10 and there may be an associated myocarditis. [11][12][13] Respiratory complications include hyperventilation, hypoxemia, respiratory depression with apnea, atelectasis, and aspiration pneumonia. 72 Either hyperthermia or hypothermia may be present, reflecting hypothalamic involvement in the infection.…”

Section: Clinical Overviewmentioning

confidence: 99%

Update on rabies

Jackson¹

2011

RRTM

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Human rabies is almost invariably fatal, and globally it remains an important public health problem. Our knowledge of rabies pathogenesis has been learned mainly from studies performed in experimental animal models, and a number of unresolved issues remain. In contrast with the neural pathway of spread, there is still no credible evidence that hematogenous spread of rabies virus to the central nervous system plays a significant role in rabies pathogenesis. Although neuronal dysfunction has been thought to explain the neurological disease in rabies, recent evidence indicates that structural changes involving neuronal processes may explain the severe clinical disease and fatal outcome. Endemic dog rabies results in an ongoing risk to humans in many resource-limited and resource-poor countries, whereas rabies in wildlife is important in North America and Europe. In human cases in North America, transmission from bats is most common, but there is usually no history of a bat bite and there may be no history of contact with bats. Physicians may not recognize typical features of rabies in North America and Europe. Laboratory diagnostic evaluation for rabies includes rabies serology plus skin biopsy, cerebrospinal fluid, and saliva specimens for rabies virus antigen and/or RNA detection. Methods of postexposure rabies prophylaxis, including wound cleansing and administration of rabies vaccine and human rabies immune globulin, are highly effective after recognized exposure. Although there have been rare survivors of human rabies, no effective therapy is presently available. Therapeutic coma (midazolam and phenobarbital), ketamine, and antiviral therapies (known as the "Milwaukee protocol") were given to a rabies survivor, but this therapy was likely not directly responsible for the favorable outcome. New therapeutic approaches for human rabies need to be developed. A better understanding of basic mechanisms involved in rabies pathogenesis may be helpful in the development of potential new therapies for the future.

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“…8). The virus may infect cardiac ganglia and the myocardium (Jackson et al 1999) and may also produce a myocarditis causing cardiac complications (Cheetham et al 1970;Metze and Feiden 1991;Raman et al 1988;Ross and Armentrout 1962).…”

Section: Rabiesmentioning

confidence: 99%

Viral Infections of the Human Nervous System

Jackson¹

2013

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Myocarditis Associated with Rabies

Cited by 56 publications

References 1 publication

Experimental Infection of Dogs and Monkeys with Two Rabies Serogroup Viruses, Lagos Bat and Mokola (IbAn 27377). Gross Pathologic and Histopathologic Changes

Experimental Infection of Dogs and Monkeys with Two Rabies Serogroup Viruses, Lagos Bat and Mokola (IbAn 27377). Gross Pathologic and Histopathologic Changes

Update on rabies

Viral Infections of the Human Nervous System

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