Antemortem diagnosis of human rabies

Human rabies is a rare but fatal disease. In the United States, the majority of people infected with rabies contract the disease by being bitten by a wild animal, most commonly bats. Because rabies is so rarely seen, it is often not diagnosed until after death, at which time exposed health care workers will require rabies prophylaxis. We describe a case for which the diagnosis was made before death. The prompt consideration of this diagnosis allowed early isolation of the patient and prevented unnecessary risk to health care workers.