Last reviewed: 4 Sep 2023
Last updated: 24 May 2019
Summary
Definition
History and exam
Key diagnostic factors
- history of mosquito bites
- fever
- arthralgias/arthritis
- rash and other dermatological manifestations
More key diagnostic factors
Other diagnostic factors
- comorbid illness
- back pain
- neuropathic-type pain
- headache
- lymphadenopathy
- ocular manifestations
- photophobia
- sore throat
- gastrointestinal manifestations
- neurologic manifestations
- hemorrhagic manifestations
Other diagnostic factors
Risk factors
- Aedes mosquito bites
- travel to/residence in endemic area
- outdoor exposure
- environmental factors favoring 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)
More risk factors
Diagnostic investigations
1st investigations to order
- CBC with differential
- LFTs
- erythrocyte sedimentation rate
- CRP
- basic metabolic panel
- serology
- molecular testing
More 1st investigations to order
Investigations to consider
- musculoskeletal imaging
- MRI brain
- cerebrospinal fluid analysis
- electromyogram
- nerve conduction studies
- electroencephalogram
- placental histology
More investigations to consider
Emerging tests
- viral culture or mice inoculation
Treatment algorithm
ACUTE
acute infection
ONGOING
longer-term arthritis: symptoms of rheumatoid arthritis
longer-term arthritis: symptoms of spondyloarthropathy
longer-term arthritis: undifferentiated polyarthritis
Contributors
Authors
Miguel G. Madariaga, MD, MSc, FACP

Infectious Diseases Consultant
Naples Community Hospital
Naples
FL
Disclosures
MGM declares that he has no competing interests.
Peer reviewers
Jessica Fairley, MD
Assistant Professor of Medicine
Division of Infectious Diseases
Emory University
Atlanta
GA
Disclosures
JF declares that she has no competing interests.
Mala Chhabra, MBBS, MD
Joint Director
National Centre for Disease Control
Delhi
India
Disclosures
MC declares that she has no competing interests.
Differentials
- Dengue fever
- Zika virus infection
- Yellow fever
More DifferentialsGuidelines
- Chikungunya virus: diagnostic testing
- Tool for the diagnosis and care of patients with suspected arboviral diseases
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