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Corneal impression test for the diagnosis of acute rabies encephalitis
1New York Medical College, Westchester County Medical Center, Valhalla 10595, USA.
Purpose:
This study aimed to alert ophthalmologists as to their role in the diagnosis of rabies.
Methods:
A 13-year-old girl was admitted with acute encephalitis of unknown etiology. Bacterial and viral cultures and test results for Lyme disease and tuberculosis were negative. Initial cerebrospinal fluid, serum, skin, and saliva specimens were negative for rabies. A corneal impression test was performed.
Results:
Immunofluorescent antibody staining of the epithelial cells on the corneal impression test was positive for rabies. Subsequently, the diagnosis was confirmed by serum serologic analysis and saliva testing.
Conclusion:
Ophthalmologists can assist in the diagnosis of rabies by using the corneal impression test. Corneal smears should be part of the routine antemortem work-up for presumptive rabies.