Incubation period:
(1) fulminant disease: 5-6 days
(2) typical: 20-60 days
(3) delayed: > 6 months
Initial findings:
(1) fever, often high
(2) malaise
(3) anxiety
(4) paresthesias, pain or pruritis at the site of animal contact
(5) headache
(6) nausea and vomiting
(7) anorexia
(8) diarrhea
(9) muscle spasms
(10) myoedema (transient mounding of muscle struck by a reflex hammer)
Early neurological signs - encephalitic form with cerebral and autonomic dysfunction ("furious"):
(1) agitation
(2) confusion, delirium or hallucinations
(3) hydrophobia or aerophobia
(4) hyperventilation
(5) hypersalivation
(6) convulsions
(7) wide swings in blood pressure
(8) biting
(9) syndrome of inappropriate ADH (SIADH) or diabetes insipidus
(10) tachycardia or bradycardia
(11) anisocoria or papillary dilation
(12) priapism in males
(13) seizures
Early neurologic signs - paralytic form ("dumb" form):
(1) ascending flaccid paralysis
(2) absence of sensory signs
(3) neck stiffness
(4) prominent headache
Late findings:
(1) coma
(2) myocarditis
(3) cardiorespiratory failure
