Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • acute onset of fever
  • headache
  • myalgia
  • arthralgia

Other diagnostic factors

  • retro-orbital pain
  • tachypnoea
  • tachycardia
  • chills
  • altered mental status
  • nausea/vomiting
  • seizures
  • GI bleeding
  • rhinorrhoea
  • cough
  • diarrhoea
  • rash
  • sore throat
  • hemiparesis
  • lethargy, drowsiness, or confusion
  • paraesthesias
  • ataxia/gait abnormalities
  • behavioural abnormalities
  • stupor, somnolence, or coma
  • neck stiffness (nuchal rigidity)
  • jaundice
  • papilloedema

Risk factors

  • living and/or working in or near tropical forests in Central or South America
  • fishing in or near tropical forests in Central or South America
  • age <15 years
  • occupational exposure (laboratory)
  • bioterrorism

Diagnostic investigations

1st investigations to order

  • reverse transcription-polymerase chain reaction (RT-PCR)
  • enzyme-linked immunosorbent assay (ELISA)
Full details

Investigations to consider

  • plaque reduction neutralisation test (PRNT)
  • viral isolation
  • CSF cell count, chemistries (glucose, protein), and viral isolation
  • FBC (including haematocrit)
  • LFTs
  • chest x-ray
  • head CT
  • brain MRI
  • rapid malaria antigen test or malaria smear
  • EEG
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor

Division of Infectious Disease and Global Medicine

University of Florida

Gainesville

FL

Disclosures

AV is funded by the National Institute of Allergy and Infectious Diseases (NIAID) for work on host susceptibility and emerging alphaviruses (2016-2021); however, the funding supports new insights in the field only, it does not directly impact any articles produced. AV is also the author of a reference cited in this monograph.

Peer reviewers VIEW ALL

Infectious Diseases Consultant

Naples Community Hospital

Naples

FL

Disclosures

MGM declares that he has no competing interests.

Research Physician

US Naval Medical Research Unit 6 (NAMRU-6)

Iquitos

Peru

Disclosures

SV declares that he has no competing interests.

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