Typhus differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Typhus must be differentiated from other diseases that cause fever, rash, diarrhea and vomiting, such as Ebola, Typhoid fever, Malaria and Lassa fever.[1][2][3][4][5]
Differentiating Typhus from other Diseases
The table below summarizes the findings that differentiate Typhus from other conditions that cause fever, diarrhea and abdominal pain.[1][2][3][4][5]
| Disease | Findings |
|---|---|
| Ebola | Presents with fever, chills vomiting, diarrhea, generalized pain or malaise, and sometimes internal and external bleeding, that follow an incubation period of 2-21 days. |
| Typhoid fever | Presents with fever, headache, rash, gastrointestinal symptoms, with lymphadenopathy, relative bradycardia, cough and leucopenia and sometimes sore throat. Blood and stool culture can confirm the presence of the causative bacteria. |
| Malaria | Presents with acute fever, headache and sometimes diarrhea (children). A blood smears must be examined for malaria parasites. The presence of parasites does not exclude a concurrent viral infection. An antimalarial should be prescribed as an empiric therapy. |
| Lassa fever | Disease onset is usually gradual, with fever, sore throat, cough, pharyngitis, and facial edema in the later stages. Inflammation and exudation of the pharynx and conjunctiva are common. |
| Yellow fever and other Flaviviridae | Present with hemorrhagic complications. Epidemiological investigation may reveal a pattern of disease transmission by an insect vector. Virus isolation and serological investigation serves to distinguish these viruses. Confirmed history of previous yellow fever vaccination will rule out yellow fever. |
| Shigellosis & other bacterial enteric infections | Presents with diarrhea, possibly bloody, accompanied by fever, nausea, and sometimes toxemia, vomiting, cramps, and tenesmus. Stools contain blood and mucous in a typical case. A search for possible sites of bacterial infection, together with cultures and blood smears, should be made. Presence of leucocytosis distinguishes bacterial infections from viral infections. |
| Others | Leptospirosis, viral hepatitis, rheumatic fever, and mononucleosis can produce signs and symptoms that may be confused with Ebola in the early stages of infection. |
References
- ↑ 1.0 1.1 Brown CS, Mepham S, Shorten RJ (2017). "Ebola Virus Disease: An Update on Epidemiology, Symptoms, Laboratory Findings, Diagnostic Issues, and Infection Prevention and Control Issues for Laboratory Professionals". Clin. Lab. Med. 37 (2): 269–284. doi:10.1016/j.cll.2017.01.003. PMID 28457350.
- ↑ 2.0 2.1 Bebell LM, Oduyebo T, Riley LE (2017). "Ebola virus disease and pregnancy: A review of the current knowledge of Ebola virus pathogenesis, maternal, and neonatal outcomes". Birth Defects Res. 109 (5): 353–362. doi:10.1002/bdra.23558. PMID 28398679.
- ↑ 3.0 3.1 Spanò S (2016). "Mechanisms of Salmonella Typhi Host Restriction". Adv. Exp. Med. Biol. 915: 283–94. doi:10.1007/978-3-319-32189-9_17. PMID 27193549.
- ↑ 4.0 4.1 Basu S, Sahi PK (2017). "Malaria: An Update". Indian J Pediatr. doi:10.1007/s12098-017-2332-2. PMID 28357581.
- ↑ 5.0 5.1 Brosh-Nissimov T (2016). "Lassa fever: another threat from West Africa". Disaster Mil Med. 2: 8. doi:10.1186/s40696-016-0018-3. PMC 5330145. PMID 28265442.