What is included in the evaluation of encephalitis when rabies is suspected?

Updated: Jun 21, 2019
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Rabies antigen can be detected in cutaneous nerves by direct fluorescent antibody. Consult with public health authorities, as these require specialized laboratories and shipping.

Corneal touch impression

Less preferably, scraping of corneal epithelia, or corneal touch impression, for direct fluorescence antibody can be used. This requires topical ocular anesthetic and is best performed by an ophthalmologist, under public health authority guidance on specimen preparation and transport. Corneal impression is obtained by pressing the surface of sterile glass slide gently but firmly onto the cornea. Corneal scrapings should be performed by an ophthalmologist unless none is available; epithelial cells are gently collected using a sterile loop or spatula and smeared carefully on a glass slide.


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