Last reviewed: November 2017
Last updated: August  2017

Summary

Definition

History and exam

Key diagnostic factors

  • hx of mosquito bites
  • fever
  • arthralgias/arthritis
  • rash and other dermatological manifestations

Other diagnostic factors

  • comorbid illness
  • back pain
  • neuropathic-type pain
  • headache
  • lymphadenopathy
  • ocular manifestations
  • photophobia
  • sore throat
  • gastrointestinal manifestations
  • neurologic manifestations
  • hemorrhagic manifestations

Risk factors

  • Aedes mosquito bites
  • travel to/residence in endemic area
  • outdoor exposure
  • environmental factors favoring breeding of mosquitoes
  • neonate with infected mother
  • low educational level
  • age >40 years
  • male gender
  • blood transfusion
  • blood group O positive
  • comorbid illnesses (risk of more severe disease)
  • neonate (risk of more severe disease)

Diagnostic investigations

1st investigations to order

  • CBC with differential
  • LFTs
  • ESR
  • CRP
  • basic metabolic panel
  • serology
  • molecular testing
Full details

Investigations to consider

  • musculoskeletal imaging
  • MRI brain
  • CSF analysis
  • EMG
  • nerve conduction studies
  • EEG
  • placental histology
Full details

Emerging tests

  • viral culture or mice inoculation
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Miguel G. Madariaga

Infectious Diseases Consultant

Naples Community Hospital

Naples

FL

Disclosures

MGM declares that he has no competing interests.

Peer reviewers VIEW ALL

Assistant Professor of Medicine

Division of Infectious Diseases

Emory University

Atlanta

GA

Disclosures

JF declares that she has no competing interests.

Joint Director

National Centre for Disease Control

Delhi

India

Disclosures

MC declares that she has no competing interests.

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