Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil

Abstract

A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 +/- 34 days). The time until death ranged from one to nine days (mean 3.3 +/- 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > or = 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.

Priapism in Dogs

“…17 Priapism was reported secondary to rabies infection in a person. 18 It was also reported with spinal injury in a dog 9 and with canine distemper virus. 5 A dysregulatory hypothesis for the pathophysiology of priapism has been postulated.…”

Comparison between early and delayed acute kidney injury secondary to infectious disease in the intensive care unit

“…Tetanus was more frequent among patients who developed AKI 24 h after admission. In some infectious diseases, such as tetanus and rabies, autonomic nervous system overactivity (characterized by intense variations in SBP and DBP, increased heart rate and elevated metanephrine excretion) has been found to be associated with renal dysfunction [37,38]. The progression of the disease, with exacerbation of autonomic nervous system dysfunction, can explain the development of AKI after admission in patients with tetanus.…”

Positive effect of organic zinc supplementation on the persistence of anti-rabies neutralizing antibodies in healthy sheep

“…The rabies vaccine was used as a model to ascertain the effect of organic Zn supplementation in the interface of nutrition and effectiveness of rabies vaccine by immune response titers and the persistence of anti-rabies neutralizing antibodies. This model is advantageous in healthy sheep that have never been in contact with the virus, as contact with virus in animals that have never been previously vaccinated will necessarily cause clinical manifestation (DAHER, 2005).…”

“…This disease is regarded as one of the most important zoonosis as it can cause fatal encephalitis in all mammals. It is distributed worldwide, and there is currently no effective therapy (DAHER, 2005). The common vampire bat (Desmodus rotundus) is widely distributed in Latin America, and is the major source of rabies virus infection in herbivores (ARELLANO-SOTA, 1988).…”