An unvaccinated 8-year-old develops fever, agitation, hydrophobia, and flaccid paralysis after a dog bite two months earlier. He dies despite supportive care. At autopsy, eosinophilic cytoplasmic inclusions are most likely to be found in which neurons?

• A Purkinje cells of the cerebellum and pyramidal neurons of the hippocampus ✓
• B Anterior horn cells of the lumbar spinal cord only
• C Neurons of the substantia nigra pars compacta
• D Betz cells of the motor cortex exclusively

Explanation

Rabies produces Negri bodies, sharply demarcated eosinophilic cytoplasmic viral inclusions, classically in Purkinje cells of the cerebellum and pyramidal neurons of the hippocampus, sites where the virus replicates after retrograde axonal travel from the bite wound. Anterior horn cell involvement explains the flaccid paralysis but Negri bodies are not restricted there. Substantia nigra neurons harbor Lewy bodies in parkinsonian disorders, and Betz cell involvement alone is not a recognized pattern.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.