Rabies is a zoonotic disease that is usually transmitted to humans by animal 
bites. Dogs are the most important vector worldwide. There are encephalitic and 
paralytic forms of the disease. There are differences in the clinical features 
of the disease acquired from dogs and bats. Neuroimaging is non-specific. 
Confirmatory diagnostic laboratory tests for rabies include detection of 
neutralizing anti-rabies virus antibodies in serum or cerebrospinal fluid and 
rabies virus antigen or RNA in tissues or fluids. Rabies is preventable after 
recognized exposures with wound cleansing and administration of rabies vaccine 
and rabies immune globulin. Rabies is virtually always fatal after clinical 
disease develops, and there have only been rare survivors. The Milwaukee 
protocol, which includes therapeutic coma, has been shown to be ineffective and 
should no longer be used. The development of novel therapeutic approaches may 
depend on a better understanding of basic mechanisms underlying the disease.