Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- fever
- constitutional symptoms
- conjunctival injection
- relative bradycardia (Faget's sign)
- biphasic illness
- haemorrhagic diathesis
- signs of renal failure
- signs of hepatic failure
- jaundice
Other diagnostic factors
- hypotension
- abdominal pain, vomiting, and lethargy
Risk factors
- residence in, or recent travel to, endemic area
- lack of immunisation
- mosquito bite
- travel during rainy and early dry seasons
Diagnostic investigations
1st investigations to order
- FBC
- liver function tests
- coagulation screen
- reverse transcription polymerase chain reaction (RT-PCR)
- serology
Investigations to consider
- ECG
- histopathology
Emerging tests
- virus isolation
- isothermal nucleic acid amplification assays
Treatment algorithm
unidentified viral haemorrhagic fever
confirmed yellow fever
Contributors
Authors
William A. Messer, MD, PhD
Associate Professor of Medicine
Department of Molecular Microbiology and Immunology
Division of Infectious Diseases
Oregon Health & Science University
Portland
PortlandOR
Disclosures
WAM declares that he has no competing interests.
Acknowledgements
Dr William A. Messer would like to gratefully acknowledge Dr Philip A. Yeon and Dr Helmut Albrecht, previous contributors to this topic.
Disclosures
PAY and HA declares that he has no competing interests.
Peer reviewers
Carlos Franco-Paredes, MD, MPH
Assistant Professor
Emory University
TravelWell Clinic
Emory University Hospital Midtown
Atlanta
GA
Disclosures
CFP declares that he has no competing interests.
Andrea K. Boggild, MSc, MD, DTMH, FRCPC
Clinical Assistant
Tropical Diseases Unit
Division of Infectious Diseases
Department of Medicine
Toronto General Hospital
University Health Network
Toronto
Canada
Disclosures
AKB declares that she has no competing interests.
Differentials
- Dengue fever
- Malaria
- Zika virus infection
More DifferentialsGuidelines
- CDC health information for international travel (Yellow Book) - yellow fever
- Yellow fever: the green book, chapter 35
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