Last reviewed: November 2017
Last updated: September  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever ≥37.5°C
  • elevated respiratory rate
  • low systolic blood pressure
  • malaise
  • nausea and vomiting
  • headache
  • sore throat/pharyngitis
  • conjunctivitis
  • chest pain/cough
  • deafness (sensorineural)
  • facial oedema
  • myalgia
  • bleeding

Other diagnostic factors

  • abdominal pain
  • diarrhoea
  • confusion and altered Glasgow Coma Scale or seizures
  • effusions

Risk factors

  • occupational exposure
  • living or working in, or arriving from, endemic areas
  • contact with infected body fluids
  • butchering and/or eating rodent meat
  • bioterrorism

Diagnostic investigations

1st investigations to order

  • reverse transcription-polymerase chain reaction (RT-PCR)
  • IgM ELISA
  • rapid diagnostic lateral flow assay
  • rapid diagnostic test for malaria
  • blood culture for diagnosis of typhoid
Full details

Investigations to consider

  • renal function and serum electrolyte
  • blood lactate/ABG
  • FBC
  • coagulation studies
  • LFTs
  • CXR
  • urinalysis
  • blood cultures
  • lumbar puncture
  • ultrasound
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Lecturer in Infectious Diseases/Virology

University College London

London

UK

Disclosures

CH declares that she has no competing interests.

Consultant in Tropical and Travel Medicine

Hospitals for Tropical Diseases

Senior Lecturer

London School of Hygiene and Tropical Medicine

London

UK

Disclosures

RB is providing expert testimony on behalf of the Crown, to the courts, on Q fever.

Peer reviewers VIEW ALL

Assistant Professor of Medicine & Pediatrics

Tulane University School of Medicine

New Orleans

LA

Disclosures

JSS is a paid reviewer and author of articles on UpToDate.

Consultant Physician

Hospital for Tropical Diseases

University College London Hospitals

London

UK

Disclosures

MB is Clinical Lead of the Hospital for Tropical Diseases, a contributing partner to the PHE Imported fever service that co-ordinates testing of samples from UK patients for viral haemorrhagic fevers.

Professor of Medicine

Perelman School of Medicine at the University of Pennsylvania

Philadelphia

PA

Disclosures

SG declares that he has no competing interests.

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