Venezuelan equine encephalitis virus infection

Last reviewed: 26 Apr 2022
Last updated: 28 Jul 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • acute onset of fever
  • headache
  • myalgia
  • arthralgia
More key diagnostic factors

Other diagnostic factors

  • retro-orbital pain
  • tachypnoea
  • tachycardia
  • chills
  • altered mental status
  • nausea/vomiting
  • seizures
  • gastrointestinal bleeding
  • rhinorrhoea
  • cough
  • diarrhoea
  • rash
  • sore throat
  • hemiparesis
  • lethargy, drowsiness, or confusion
  • paraesthesias
  • ataxia/gait abnormalities
  • behavioural abnormalities
  • stupor, somnolence, or coma
  • neck stiffness (nuchal rigidity)
  • jaundice
  • papilloedema
Other diagnostic factors

Risk factors

  • living and/or working in or near tropical forests in Central or South America
  • fishing in or near tropical forests in Central or South America
  • age <15 years
  • occupational exposure (laboratory)
  • bioterrorism
More risk factors

Diagnostic investigations

1st investigations to order

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

Investigations to consider

  • plaque reduction neutralisation test (PRNT)
  • viral isolation
  • cerebrospinal fluid cell count, chemistries (glucose, protein), and viral isolation
  • FBC (including haematocrit)
  • LFTs
  • chest x-ray
  • head CT
  • brain MRI
  • rapid malaria antigen test or malaria smear
  • electroencephalogram
More investigations to consider

Treatment algorithm

ACUTE

symptomatic patients

Contributors

Authors

Amy Vittor, MD, PhD

Assistant Professor

Division of Infectious Disease and Global Medicine

University of Florida

Gainesville

FL

Disclosures

AV is funded by the National Institute of Allergy and Infectious Diseases (NIAID) for work on host susceptibility and emerging alphaviruses (2016-2021); however, the funding supports new insights in the field only, it does not directly impact any articles produced. AV is a recipient of an NIH NIAID K08 award. AV is also the author of a reference cited in this topic.

Peer reviewers

Miguel G. Madariaga, MD, MSc, FACP

Infectious Diseases Consultant

Naples Community Hospital

Naples

FL

Disclosures

MGM declares that he has no competing interests.

Stalin Vilcarromero, MD

Research Physician

US Naval Medical Research Unit 6 (NAMRU-6)

Iquitos

Peru

Disclosures

SV declares that he has no competing interests.

  • Venezuelan equine encephalitis virus infection images
  • Differentials

    • Malaria infection
    • Dengue fever
    • Chikungunya virus
    More Differentials
  • Guidelines

    • Management of suspected viral encephalitis in adults- Association of British Neurologists and British Infection Association national guidelines
    • Management of suspected viral encephalitis in children- Association of British Neurologists and British Paediatric Allergy, Immunology and Infection Group national guidelines
    More Guidelines
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