West nile virus differential diagnosis: Difference between revisions

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{{West nile virus}}
{{West nile virus}}
{{CMG}}
{{CMG}} {{AE}} {{AL}}


==Overview==
==Overview==
West nile virus infection must be differentiated from other diseases that cause [[skin rash]], [[fever]], [[headaches]], and [[altered mental status]], such as: herpes virus encephalitis, enterovirus encephalitis, bacterial encephalitis, metabolic encephalitis, poliomyelitis,
West Nile fever must be differentiated from other diseases that cause [[fever]], [[skin rash]], [[myalgias]], and [[back pain]], such as other viral infections due to [[rhinovirus]], [[enterovirus D68]], [[coxsackievirus]], [[influenza]], [[echovirus]]. Patients with severe WNV infection may present with [[meningitis]], [[encephalitis]], or [[flaccid paralysis]]. These diseases must be differentiated from other diseases that cause severe [[headache]], [[altered mental status]], [[seizures]], and [[paralysis]], such as [[herpes virus]] [[encephalitis]], enterovirus [[encephalitis]], bacterial [[encephalitis]], metabolic [[encephalitis]], [[poliomyelitis]], and [[Guillain-Barre syndrome]].


==Differential Diagnosis==
==Differential Diagnosis==
====Differential diagnosis of West Nile fever====
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|valign=top|
|valign=top|
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Disease}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Findings}}
|-
| style="padding: 5px 5px; background: #DCDCDC;"|
*[[Rhinovirus]] infection
|-
| style="padding: 5px 5px; background: #F5F5F5;"|
*[[Enterovirus D68]] infection
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[HSV encephalitis]]
| style="padding: 5px 5px; background: #DCDCDC;"|
| style="padding: 5px 5px; background: #F5F5F5;" | [[Headache]], [[fever]], history of [[herpes virus]] infection
*[[Coxsackievirus]] infection
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Enterovirus encephalitis
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |Encephalitis symptoms associated with [[sore throat]], [[diarrhea]], [[skin rash]], and [[altered mental status]].
*[[Influenza]] infection
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Metabolic and toxic encephalopathy
| style="padding: 5px 5px; background: #DCDCDC;"|
| style="padding: 5px 5px; background: #F5F5F5;" | The majority of patients present with [[altered mental status]], additional findings include signs of [[uremia]], [[electrolyte]] disturbances, and history of drug intake or overdose.
*[[Rocky Mountain spotted fever]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Bacterial encephalitis]]
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" |Patients present with altered mental status, toxic-appearance, [[fever]], [[CSF]] findings will include high level of [[neutrophils]], high [[protein]] and low [[glucose]] levels.
*[[Chikungunya virus]] infection
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Guillain-Barré syndrome]]
| style="padding: 5px 5px; background: #DCDCDC;"|
| style="padding: 5px 5px; background: #F5F5F5;" |Often presents with distal, ascending, symmetrical [[paralysis]] with abolished [[reflexes]], and it is associated with a recent viral or bacterial [[gastroenteritis]].
*[[Dengue fever]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Acute [[Poliomyelitis]]
|}
| style="padding: 5px 5px; background: #F5F5F5;" | Patients may present with [[flaccid paralysis]]
 
====Differential diagnosis of severe West Nile virus infection====
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
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! style="background: #4479BA; width: 250px;" | {{fontcolor|#FFF|West Nile Virus Presentation}}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Differential Diagnosis<ref name="RossiRoss2010">{{cite journal|last1=Rossi|first1=Shannan L.|last2=Ross|first2=Ted M.|last3=Evans|first3=Jared D.|title=West Nile Virus|journal=Clinics in Laboratory Medicine|volume=30|issue=1|year=2010|pages=47–65|issn=02722712|doi=10.1016/j.cll.2009.10.006}}</ref><ref>{{Cite journal | author = [[T. F. Tsai]] | title = Arboviral infections in the United States | journal = [[Infectious disease clinics of North America]] | volume = 5 | issue = 1 | pages = 73–102 | year = 1991 | month = March | pmid = 1646839 }}</ref>}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |West Nile Virus Encephalitis and Meningitis
| style="padding: 5px 5px; background: #F5F5F5;" | [[Herpes simplex virus]], [[coxsackievirus]], [[echovirus]], other [[arbovirus]], [[metabolic encephalopathy]], [[bacterial meningitis]], [[St. Louis encephalitis]], [[eastern equine encephalitis virus]], [[western equine encephalitis]], [[Lyme disease]].
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |West Nile Virus Flaccid Paralysis
| style="padding: 5px 5px; background: #F5F5F5;" | Acute [[poliomyelitis]], [[Guillain-Barre syndrome]], [[stroke]], [[myasthenia gravis]]
|}
|}


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[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]
 
[[Category:Neurology]]
[[Category:Neurology]]

Latest revision as of 19:11, 18 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

West Nile fever must be differentiated from other diseases that cause fever, skin rash, myalgias, and back pain, such as other viral infections due to rhinovirus, enterovirus D68, coxsackievirus, influenza, echovirus. Patients with severe WNV infection may present with meningitis, encephalitis, or flaccid paralysis. These diseases must be differentiated from other diseases that cause severe headache, altered mental status, seizures, and paralysis, such as herpes virus encephalitis, enterovirus encephalitis, bacterial encephalitis, metabolic encephalitis, poliomyelitis, and Guillain-Barre syndrome.

Differential Diagnosis

Differential diagnosis of West Nile fever
Differential Diagnosis

Differential diagnosis of severe West Nile virus infection
West Nile Virus Presentation Differential Diagnosis[1][2]
West Nile Virus Encephalitis and Meningitis Herpes simplex virus, coxsackievirus, echovirus, other arbovirus, metabolic encephalopathy, bacterial meningitis, St. Louis encephalitis, eastern equine encephalitis virus, western equine encephalitis, Lyme disease.
West Nile Virus Flaccid Paralysis Acute poliomyelitis, Guillain-Barre syndrome, stroke, myasthenia gravis

References

  1. ↑ Rossi, Shannan L.; Ross, Ted M.; Evans, Jared D. (2010). "West Nile Virus". Clinics in Laboratory Medicine. 30 (1): 47–65. doi:10.1016/j.cll.2009.10.006. ISSN 0272-2712.
  2. ↑ T. F. Tsai (1991). "Arboviral infections in the United States". Infectious disease clinics of North America. 5 (1): 73–102. PMID 1646839. Unknown parameter |month= ignored (help)


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