Typhus differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Typhus]]
{{CMG}}; {{AE}} {{JS}}


{{Typhus}}
==Overview==
Typhus must be differentiated from other diseases that cause [[fever]], rash, [[diarrhea]] and [[vomiting]], such as [[Ebola]], [[Typhoid fever]], [[Malaria]] and [[Lassa fever]].<ref name="pmid28457350">{{cite journal |vauthors=Brown CS, Mepham S, Shorten RJ |title=Ebola Virus Disease: An Update on Epidemiology, Symptoms, Laboratory Findings, Diagnostic Issues, and Infection Prevention and Control Issues for Laboratory Professionals |journal=Clin. Lab. Med. |volume=37 |issue=2 |pages=269–284 |year=2017 |pmid=28457350 |doi=10.1016/j.cll.2017.01.003 |url=}}</ref><ref name="pmid28398679">{{cite journal |vauthors=Bebell LM, Oduyebo T, Riley LE |title=Ebola virus disease and pregnancy: A review of the current knowledge of Ebola virus pathogenesis, maternal, and neonatal outcomes |journal=Birth Defects Res |volume=109 |issue=5 |pages=353–362 |year=2017 |pmid=28398679 |doi=10.1002/bdra.23558 |url=}}</ref><ref name="pmid27193549">{{cite journal |vauthors=Spanò S |title=Mechanisms of Salmonella Typhi Host Restriction |journal=Adv. Exp. Med. Biol. |volume=915 |issue= |pages=283–94 |year=2016 |pmid=27193549 |doi=10.1007/978-3-319-32189-9_17 |url=}}</ref><ref name="pmid28357581">{{cite journal |vauthors=Basu S, Sahi PK |title=Malaria: An Update |journal=Indian J Pediatr |volume= |issue= |pages= |year=2017 |pmid=28357581 |doi=10.1007/s12098-017-2332-2 |url=}}</ref><ref name="pmid28265442">{{cite journal |vauthors=Brosh-Nissimov T |title=Lassa fever: another threat from West Africa |journal=Disaster Mil Med |volume=2 |issue= |pages=8 |year=2016 |pmid=28265442 |pmc=5330145 |doi=10.1186/s40696-016-0018-3 |url=}}</ref>


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==Differentiating Typhus from other Diseases==
The table below summarizes the findings that differentiate [[Typhus]] from other conditions that cause [[fever]], [[diarrhea]] and [[abdominal pain]].<ref name="pmid28457350">{{cite journal |vauthors=Brown CS, Mepham S, Shorten RJ |title=Ebola Virus Disease: An Update on Epidemiology, Symptoms, Laboratory Findings, Diagnostic Issues, and Infection Prevention and Control Issues for Laboratory Professionals |journal=Clin. Lab. Med. |volume=37 |issue=2 |pages=269–284 |year=2017 |pmid=28457350 |doi=10.1016/j.cll.2017.01.003 |url=}}</ref><ref name="pmid28398679">{{cite journal |vauthors=Bebell LM, Oduyebo T, Riley LE |title=Ebola virus disease and pregnancy: A review of the current knowledge of Ebola virus pathogenesis, maternal, and neonatal outcomes |journal=Birth Defects Res |volume=109 |issue=5 |pages=353–362 |year=2017 |pmid=28398679 |doi=10.1002/bdra.23558 |url=}}</ref><ref name="pmid27193549">{{cite journal |vauthors=Spanò S |title=Mechanisms of Salmonella Typhi Host Restriction |journal=Adv. Exp. Med. Biol. |volume=915 |issue= |pages=283–94 |year=2016 |pmid=27193549 |doi=10.1007/978-3-319-32189-9_17 |url=}}</ref><ref name="pmid28357581">{{cite journal |vauthors=Basu S, Sahi PK |title=Malaria: An Update |journal=Indian J Pediatr |volume= |issue= |pages= |year=2017 |pmid=28357581 |doi=10.1007/s12098-017-2332-2 |url=}}</ref><ref name="pmid28265442">{{cite journal |vauthors=Brosh-Nissimov T |title=Lassa fever: another threat from West Africa |journal=Disaster Mil Med |volume=2 |issue= |pages=8 |year=2016 |pmid=28265442 |pmc=5330145 |doi=10.1186/s40696-016-0018-3 |url=}}</ref>
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Disease}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Findings}}
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Ebola]]'''
| style="padding: 5px 5px; background: #F5F5F5;" | Presents with [[fever]], [[chills]] [[vomiting]], [[diarrhea]], generalized [[pain]] or [[malaise]], and sometimes [[Internal bleeding|internal]] and external [[bleeding]], that follow an [[incubation period]] of 2-21 days.
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Typhoid fever]]'''
| style="padding: 5px 5px; background: #F5F5F5;" | 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.
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Malaria]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |Presents with acute [[fever]], [[headache]] and sometimes [[diarrhea]] (children). A [[blood smear]]s 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]].
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Lassa fever]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |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.
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Yellow fever]] and other [[Flaviviridae]] '''
| style="padding: 5px 5px; background: #F5F5F5;" | Present with [[hemorrhage|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]].
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Shigellosis]] & other bacterial enteric infections'''
| style="padding: 5px 5px; background: #F5F5F5;" | Presents with [[diarrhea]], possibly [[Dysentery|bloody]], accompanied by [[fever]], [[nausea]], and sometimes [[toxemia]], [[vomiting]], [[cramps]], and [[tenesmus]]. [[Stool]]s contain [[blood]] and mucous in a typical case. A search for possible sites of bacterial infection, together with cultures and [[blood smear]]s, should be made. Presence of [[leucocytosis]] distinguishes bacterial infections from [[viral infections]].
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Others'''
| style="padding: 5px 5px; background: #F5F5F5;" |[[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==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


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Latest revision as of 00:32, 30 July 2020

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. ↑ 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. ↑ 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. ↑ 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. ↑ 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. ↑ 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.

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