鉴别诊断
Malaria
征象/症状
Most common cause of nonspecific febrile illness in returning travelers.[115]
Inadequate or no malaria chemoprophylaxis.
There are no differentiating signs and symptoms.
Co-infection with malaria was seen in up to 5% of patients in West Africa during the 2014 outbreak, so the possibility of dual infection should be considered in all patients.[96]
辅助检查
Giemsa-stained thick and thin blood smears: positive for Plasmodium species.
Rapid diagnostic tests: positive for Plasmodium species (note: P ovale is not always detected by some rapid diagnostic tests).
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Marburg disease
征象/症状
There are no differentiating signs and symptoms.
Epidemiologic features can help differentiate between the viral hemorrhagic fevers (i.e., exposure to bats, caves, or mining).
辅助检查
Reverse transcriptase-polymerase chain reaction (RT-PCR): positive for an Orthomarburgvirus RNA.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Crimean-Congo hemorrhagic fever (CCHF)
征象/症状
There are no differentiating signs and symptoms.
Epidemiologic features can help differentiate between the viral hemorrhagic fevers (i.e., animal butchering, tick bite, or exposure to animals).
辅助检查
RT-PCR: positive for CCHF virus RNA.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Lassa fever
征象/症状
There are no differentiating signs and symptoms.
Epidemiologic features can help differentiate between the viral hemorrhagic fevers (i.e., exposure to rats in endemic areas).
辅助检查
RT-PCR: positive for Lassa virus RNA.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Rift Valley fever
征象/症状
There are no differentiating signs and symptoms.
Epidemiologic features can help differentiate between the viral hemorrhagic fevers (i.e., mosquito exposure, livestock handling, consuming raw animal fluids/tissues).
辅助检查
RT-PCR: positive for Rift Valley fever virus RNA.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Yellow fever
征象/症状
There are no differentiating signs and symptoms.
Epidemiologic features can help differentiate between the viral hemorrhagic fevers (i.e., mosquito exposure, lack of immunization).
辅助检查
RT-PCR: positive for yellow fever virus RNA.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Dengue fever
征象/症状
There are no differentiating signs and symptoms, although epidemiologic clues may be helpful (i.e., Caribbean, Southeast Asia, Oceania, Central and South America, sub-Saharan Africa).
辅助检查
Serology: positive IgM or IgG.
Nonstructural protein (NS1) detection: positive.
RT-PCR: positive for dengue virus RNA.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Typhoid infection
征象/症状
There are no differentiating signs and symptoms.
辅助检查
Blood or stool culture: positive for Salmonella enterica.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Rickettsial infections
征象/症状
Includes murine typhus, African tick-bite fever, and epidemic typhus.[134]
Eschar is typical.
Lymphadenopathy may be present.
Discrete rash.
辅助检查
Serology: positive for Rickettsia species.
Eschar polymerase chain reaction (PCR): positive for Rickettsia species RNA.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Measles infection
征象/症状
Unvaccinated.
There are no differentiating signs and symptoms in prodromal phase.
Koplik spots (red spots with bluish-white central dot) on buccal mucosa.
Rash typically starts on face and spreads craniocaudally.
辅助检查
Serology: positive for measles virus antibodies.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Leptospirosis
征象/症状
There are no differentiating signs and symptoms; however, a history of exposure may be helpful.
Exposure to contaminated water or soil contaminated by infected rodents.[135]
More common in tropical climates.
辅助检查
PCR: positive leptospira RNA.
Serology: positive leptospira antibodies.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Influenza infection
征象/症状
Respiratory signs and symptoms (e.g., cough, nasal congestion) are more common.
辅助检查
Viral culture or PCR: detection of seasonal influenza virus or viral RNA.
CBC: normal.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Coronavirus disease 2019 (COVID-19)
征象/症状
Important to consider current epidemiologic situation. May give history of unwell contacts.
Respiratory symptoms may be prominent.
辅助检查
Real time RT-PCR: positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. Rapid antigen tests may also be used.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Gastroenteritis
征象/症状
In the correct epidemiologic text, this can present in a similar way to Ebola disease. However, features such as rash, conjunctival injection, and prostration are very rare in gastroenteritis.
辅助检查
Stool culture, PCR, or rapid antigen testing: positive for causative agent.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
Sepsis
征象/症状
Bacterial sepsis with an unclear origin is a common presentation in developing countries. Often turns out to be deep abdominal infection, upper urinary tract infection, endocarditis, or discitis.
Diarrhea is often absent.
辅助检查
Blood cultures: positive, although positive blood cultures may occur in Ebola disease as well.
It is recommended that appropriate confirmatory tests for Ebola disease are performed before, or in tandem with, differentiating tests if Ebola disease is suspected.
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