The adrenal glands and the central nervous system were studied from five human cases of rabies who died three to six days after first rings of clinical manifestations were seen. In all cases there Negri bodies in the cytoplasm of neurons of the central nervous system and mononuclear inflammatory cells around blood vessels, more intense in the cases with longer survival. Only the adrenal medulla showed diffuse and intense mononuclear exudate associated with pheocromocytes alterations in 60% of patients. Eosinophylic bodies were found in the cytoplasm of pheochromocytes and in the intersticial space. These bodies may be similar to Negri bodies but their true nature it is not known. The pathogenesis of adrenal medulitis in rabies may be related to embriological and metabolical relationships of the chromaffin system and the nervous system.
human rabies encephalitis; rabiesvirus; adrenal medulitis; adrenalitis