Is the patient comatose/intubated?
Most patients with rabies infections will lapse into coma and life support is required within a short period of time. If a patient has been placed on life support and then recovered enough for it to be removed, rabies can be ruled out. Likewise it can be ruled out on a patient on life support whose condition has not progressively worsened. • Has the patient’s condition improved? With many conditions, improvements and relapses are fairly common. This is not so with rabies, as the course of the disease is relentlessly downhill. Once symptoms begin, the patient will steadily deteriorate until death. Rabies can be ruled out in patients whose conditions improve. • Has limited access to the patient been established? If the facility has not yet instituted these precautions, why does the physician feel that rabies should be high on the list of differential diagnoses? Additionally, if the physician does feel that rabies is a valid possibility, these precautions need to be taken immediately. • I
