Corneal impression test for the diagnosis of acute rabies encephalitis.

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.