What is the role of viral cultures and polymerase chain reaction (PCR) assay in the workup of rabies?

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

Consult with public health authorities, as these require specialized laboratories and shipping. The following may be used:

  • Saliva - Results of saliva culture for rabies virus are positive in low yield within 2 weeks of illness onset
  • Cerebrospinal fluid - After the first week of illness, 80% monocytosis may be observed; protein levels may be elevated, and glucose test results are normal. However, spinal fluid may also be normal.
  • Brain tissue - Often postmortem; staining with immunohistochemical or florescent antibody staining is definitive. Negri bodies are pathognomonic (cytoplasmic inclusion bodies reflective of accumulated virions within rabies-infected neurons). They are found in the horn of Ammon of the hippocampus and cerebral cortex

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