Last reviewed: 26 Jan 2021
Last updated: 24 May 2019
Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- history 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
- neurological manifestations
- haemorrhagic manifestations
Risk factors
- Aedes mosquito bites
- travel to/residence in endemic area
- outdoor exposure
- environmental factors favouring breeding of mosquitoes
- neonate with infected mother
- low educational level
- age >40 years
- male sex
- 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
- FBC with differential
- LFTs
- erythrocyte sedimentation rate
- CRP
- basic metabolic panel
- serology
- molecular testing
Investigations to consider
- musculoskeletal imaging
- MRI brain
- cerebrospinal fluid analysis
- electromyogram
- nerve conduction studies
- electroencephalogram
- placental histology
Treatment algorithm
Contributors
Authors

Infectious Diseases Consultant
Naples Community Hospital
Naples
FL
Disclosures
MGM declares that he has no competing interests.
Peer reviewers
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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