Last reviewed: June 2018
Last updated: February  2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever (≥37.5°C)
  • headache
  • seizures

Other diagnostic factors

  • nausea/vomiting
  • myalgias/arthralgias
  • neck stiffness (nuchal rigidity)
  • focal weakness (decreased motor function)
  • photophobia
  • abdominal pain
  • altered mental status
  • cranial nerve palsy
  • tremors
  • drowsiness
  • meningismus
  • diarrhoea
  • cerebral oedema
  • intracranial hypertension
  • aseptic meningitis
  • haemophagocytic lymphohistiocytosis
  • hemiparesis

Risk factors

  • travel/residence in endemic areas
  • working in endemic areas
  • outdoor recreational activities in endemic areas
  • seasonal factors favouring breeding of mosquitoes
  • age <15 years or >50 years
  • occupational exposure (laboratory)
  • bioterrorism

Diagnostic investigations

1st investigations to order

  • enzyme-linked immunosorbent assay (ELISA)
  • MRI brain
  • plaque reduction neutralisation test (PRNT)
  • FBC
  • basic metabolic panel
Full details

Investigations to consider

  • CSF studies
  • CT brain
  • 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 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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