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

Revista do Instituto de Medicina Tropical de São Paulo

Elizabeth De Francesco Daher¹  Geraldo Bezerra Da Silva Júnior¹  Marúsia Thomaz Ferreira¹  Fernando Antonio De Sousa Barros¹  Tiago Magalhães Gurgel²  Régia Maria Do Socorro Vidal Patrocínio² 

[1] ,Universidade Federal do Ceará Faculdade de Medicina Departamento de Medicina ClínicaFortaleza CE ,Brasil

关键词: Rabies;    Clinical manifestations;    Acute renal failure;    Pathology;    Autopsy;   

DOI  :  10.1590/S0036-46652005000600002

来源: SciELO

【 摘 要 】

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 > 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.

【 授权许可】

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