In this article, we will discuss the Pathogenesis of Rabies So, let’s get started.
Th incubation period of rabies is between 20-90 days but it is extended up to 1 year in rare cases. Following inoculation of the virus by a dog bite, cat bite, or monkey bite, etc the virus binds to neuromuscular junction and multiplies in the muscles, then it spreads centrifugally along the peripheral nerves to the spinal cord and brain. Once the virus enters the CNS, it rapidly disseminates to other regions of the CNS along with neuroanatomic connections. Neurons are mainly attacked by the virus. After CNS infection becomes established it spreads centrifugally along the sensory and autonomic nerves to the salivary glands, eye, skin, and other organs.
In this article, we will discuss the WHO Criteria for Severe Cerebral Malaria (falciparum malaria). So, let’s get started.
WHO Criteria for Severe Cerebral Malaria (falciparum malaria)
- Cerebral malaria (unexplained unarousable coma)
- Severe anemia (Hb <5 g/dl or hematocrit <15%)
- Renal failure (oliguria-urine output <400 ml/day or <12 ml/kg/day plus serum creatinine >3 mg/dl or 265 μmol/L)
- Non-cardiogenic pulmonary edema (ARDS*, hypoxemia, respiratory failure)
- Hypoglycemia (whole blood glucose <40 mg/dl or 2.2 mmol/L)
- Circulatory collapse (systolic BP <70 mmHg with cold clammy extremities)
- Spontaneous bleeding, DIC** (prolonged PT***, PTT***), and thrombocytopenia
- Repeated generalized convulsions (>3 in 24 hours)
- Acidemia (arterial pH <7.25) or acidosis (plasma bicarbonate <15 mmol/L)
- Hemoglobinuria (not drug-induced)
- Jaundice (icterus or serum bilirubin >3 mg/dl)
- Hyperparasitemia (>5% in non-immune patients or >10,000/ml)
Some important medical abbreviations
- *ARDS: Acute respiratory distress syndrome
- **DIC: Disseminated Intravascular Coagulation
- ***PT: Prothrombin time
- ****PTT: Partial thromboplastin time