South American haemorrhagic fevers

Last reviewed: 26 Apr 2022
Last updated: 05 Nov 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever ≥37.5°C
  • bleeding (gums, epistaxis, gastrointestinal, metrorrhagia)
  • petechiae
  • conjunctivitis
More key diagnostic factors

Other diagnostic factors

  • malaise
  • headache
  • arthralgia
  • myalgia
  • abdominal pain
  • nausea/vomiting
  • diarrhoea
  • lymphadenopathy
  • neurological symptoms (e.g., confusion, ataxia, seizures)
  • sore throat
  • cough
  • prostration/coma
Other diagnostic factors

Risk factors

  • occupational exposure
  • exposure to relevant rodent species
  • adult males
  • contact with infected person
  • dwelling in endemic area
More risk factors

Diagnostic investigations

1st investigations to order

  • reverse transcription-polymerase chain reaction (RT-PCR)
  • enzyme-linked immunosorbent assay (ELISA)
  • FBC
More 1st investigations to order

Investigations to consider

  • malaria screen
  • blood culture
  • electrolytes and renal function
  • liver function
  • coagulation screen
  • lactate dehydrogenase
  • creatine phosphokinase
  • CXR
  • arterial blood gas
More investigations to consider

Treatment algorithm

ACUTE

symptomatic patients

Contributors

Authors

Nathalie MacDermott, MBBCh

Wellcome Clinical Research Training Fellow

Imperial College London

London

UK

Disclosures

NMD declares that she has no competing interests.

Thomas G. Ksiazek, DVM, PhD

Professor

University of Texas Medical Branch (UTMB) at Galveston

Galveston

TX

Disclosures

TGK has grants and contracts from NIH but is not involved in drug or vaccine research relating to South American haemorrhagic fevers. He has patents in regard to Ebola, Rift Valley fever, and hantaviruses. TGK is an author of a reference cited in this topic.

Peer reviewers

Stalin Vilcarromero, MD

Research Physician

US Naval Medical Research Unit 6 (NAMRU-6)

Iquitos

Peru

Disclosures

SV declares that he has no competing interests.

Vanessa Raabe, MD, MSc

Adult and Pediatric Infectious Disease Fellow

Emory University

Atlanta

GA

Disclosures

VR declares that she has no competing interests.

  • South American haemorrhagic fevers images
  • Differentials

    • Malaria infection
    • Dengue fever
    • Yellow fever
    More Differentials
  • Guidelines

    • CDC Health Information for International Travel (Yellow Book): viral hemorrhagic fevers
    • Management of Hazard Group 4 viral haemorrhagic fevers and similar human infectious diseases of high consequence
    More Guidelines
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