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Extraneural
Organ Involvement in Human Rabies |
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Alan C. Jackson,
Hongtao Ye, Cynthia C. Phelan, Cecilia Ridaura-Sanz, Qian Zheng, Zhishang
Li, Xiaoqiang Wan, Eduardo Lopez-Corella |
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Departments of Medicine (ACJ,
HY, CCP) and Microbiology and Immunology (ACJ, QZ), Queen's University,
Kingston, Ontario, Canada; Department of Pathology (CR-S, EL-C), Instituto
Nacional de Pediatria, Mexico City, Mexico; and Department of Pathology
(ZL, XW), Guangxi Medical University, Nanning, Guangxi, People's Republic
of China |
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SUMMARY: Human rabies is
a fatal encephalomyelitis. After the development of the central nervous
system infection, there is centrifugal spread of the rabies virus to extraneural
(systemic) organs. With histochemical staining and localization of rabies
virus antigen (RVA) with immunoperoxidase staining, we have examined tissue
sections of organs from 14 postmortem pediatric and adult cases of human
rabies acquired in Mexico and the People\'s Republic of China. RVA was found
in nerve plexuses in multiple organs, including the gastrointestinal tract.
RVA was observed in muscle fibers of the heart, tongue, and larynx. RVA
frequently was observed in the adrenal medulla with an associated inflammatory
reaction. Minor salivary glands of the tongue contained RVA and major salivary
glands showed RVA in plexuses, but not in either acini or ducts. Epithelial
cells of the tongue and taste buds were occasionally infected. RVA was observed
in hair follicles of the skin and rarely in pancreatic islets. The infection
of extraneural organs was sometimes, but not always, associated with an
inflammatory reaction. These findings indicate that centrifugal spread of
rabies virus to extraneural organs occurs frequently in human rabies. |
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