Zika virus infection differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Zika virus}} | {{Zika virus}} | ||
{{CMG}}; {{AE}} {{LRO}} | {{CMG}}; {{AE}} {{YD}}; {{LRO}}; {{SSK}}; {{YK}} | ||
==Overview== | ==Overview== | ||
The broad-ranging clinical symptoms associated with Zika virus infection commonly cause it to be misdiagnosed with multiple similar diseases that are also from the [[Flaviviridae|Flaviviridae]] [[virus]] family. Zika virus infection has similar clinical presentation to [[Dengue fever|dengue]] fever, [[Yellow fever|yellow fever]], [[West nile virus|West Nile virus]], and [[Japanese encephalitis|Japanese encephalitis]]. Zika virus infection is distinct in its milder clinical manifestations and shorter length of infection. The association between Zika virus infection and complications that include [[congenital]] anomalies and [[neurological]] syndromes is also distinctive. Of note, patients bitten by [[mosquitoes]] may be concomitantly infected with Zika virus and other [[mosquito]]-borne infections, and co-infection should always be considered. | |||
==Differentiating Zika Virus | ==Differentiating Zika Virus Infection from Other Diseases== | ||
*Zika virus infection manifests through a broad range of clinical symptoms shared with multiple different diseases from the Flaviviridae | *Zika virus infection manifests through a broad range of clinical symptoms shared with multiple different diseases from the Flaviviridae virus family, causing misdiagnosis to be common with the following diseases:<ref name= “Zika Medicaltherapy”> Zika virus. Center for Disease Control and Prevention for Medical Professionals. http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html Accessed on December 10, 2015</ref> | ||
**[[Dengue fever]] | **[[Dengue fever]] | ||
**[[Malaria]] | **[[Malaria]] | ||
| Line 15: | Line 15: | ||
**[[Adenovirus]] | **[[Adenovirus]] | ||
**[[Alphavirus]] | **[[Alphavirus]] | ||
**[[Rickettsia]] | **[[Rickettsia rickettsii infection|Rickettsia]] | ||
**[[Streptococcus|Group A Streptococcus]] | **[[Streptococcus|Group A Streptococcus]] | ||
**[[Rubella]] | **[[Rubella]] | ||
**[[Measles]] | **[[Measles]] | ||
**[[Chikungunya]] | **[[Chikungunya]] | ||
**[[Yellow fever]] | |||
**[[West Nile virus]] | |||
**[[Japanese encephalitis]] | |||
**[[O'nyong'nyong virus]] | |||
**[[Ross River virus]] | |||
**[[Barmah Forest virus]] | |||
**[[Sindbis virus]] | |||
*Of note, patients bitten by [[mosquitoes]] may be concomitantly infected with Zika virus and other [[mosquito]]-borne infections, and co-infection should always be considered. | |||
*Zika virus infection is clinically distinct from similar diseases by its typically mild symptoms and short length, with symptoms typically lasting 4-7 days total and not requiring hospitalization.<ref name= “ZikaEmergingDiseases”> Outbreak of Exanthematous Illness Associated with Zika, Chikungunya, and Dengue Viruses, Salvador, Brazil. Emerging Infectious Diseases; Center for Disease Control. http://wwwnc.cdc.gov/eid/pdfs/vol21no12_pdf-version.pdf Accessed on December 16, 2015</ref> | |||
*Zika virus infection-related complications, such as [[Microcephaly|microcephaly]] and [[Guillain-Barré syndrome|Guillain-Barré syndrome]], distinguish Zika virus infection from other Flaviviridae Virus diseases.<ref name="EpiAlert">{{cite web |url=http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=32405&lang=en |title=Epidemiological Alert: Neurological Syndromes, Congenital Malformations, and Zika Virus Infection. Implications for Public Health in the Americas |last1= |first1= |last2= |first2= |date=December 1, 2015 |website=Pan American Health Organization|publisher=Pan American Health Organization |access-date=December 11, 2015 |quote=}}</ref> | |||
==Differentiating Zika Fever from Dengue Fever== | |||
The following table summarizes the distinguishing and common features between Zika fever and [[Dengue fever]], both of which are transmitted by the ''Aedes'' [[mosquito]]: | |||
{| class="wikitable" | |||
| align="center" style="background:#f0f0f0; width: 10%;"| | |||
| align="center" style="background:#f0f0f0; width: 25%;"|'''Dengue Fever''' | |||
| align="center" style="background:#f0f0f0; width: 25%;"|'''Zika Fever''' | |||
|- | |||
| '''Common Clinical Features'''||Biphasic [[fever]] pattern, [[maculopapular rash]], arthralgia, [[headache]], and signs of [[hemorrhage]]||[[Fever]], [[maculopapular rash]], [[conjunctivitis]], and [[headache]] | |||
|- | |||
| '''Hemorrhage Common?'''||Yes||No | |||
|- | |||
| '''Symptom Severity'''||May be severe||Usually mild | |||
|- | |||
| '''Symptom Duration'''||2 to 7 days||4 to 7 days | |||
|- | |||
| '''Incubation Period'''||4 to 10 days||3 to 12 days | |||
|- | |||
| '''Endemicity'''||Americas, Africa, Southeast Asia||Americas, Africa, Southeast Asia | |||
|- | |||
| '''Vector'''||''Aedes'' [[mosquito]]||''Aedes'' [[mosquito]] | |||
|- | |||
| '''Laboratory Findings'''||Leucopenia, rising [[hematocrit]] (suggestive of impending [[hemorrhage]]), [[thrombocytopenia]], elevated liver function tests||Leucopenia but normal [[hematocrit]], [[platelet]] count, and [[liver function tests]] | |||
|- | |||
| '''Diagnosis'''||[[RT-PCR]] or [[ELISA]]||[[RT-PCR]] or [[ELISA]] | |||
|- | |||
| '''Treatment'''||Supportive care, avoid [[aspirin]] and other [[NSAIDs]]||Supportive care | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Dermatology]] | |||
[[Category:Pulmonology]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Neurology]] | |||
Latest revision as of 00:46, 30 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Luke Rusowicz-Orazem, B.S.; Serge Korjian M.D.; Yamuna Kondapally, M.B.B.S[2]
Overview
The broad-ranging clinical symptoms associated with Zika virus infection commonly cause it to be misdiagnosed with multiple similar diseases that are also from the Flaviviridae virus family. Zika virus infection has similar clinical presentation to dengue fever, yellow fever, West Nile virus, and Japanese encephalitis. Zika virus infection is distinct in its milder clinical manifestations and shorter length of infection. The association between Zika virus infection and complications that include congenital anomalies and neurological syndromes is also distinctive. Of note, patients bitten by mosquitoes may be concomitantly infected with Zika virus and other mosquito-borne infections, and co-infection should always be considered.
Differentiating Zika Virus Infection from Other Diseases
- Zika virus infection manifests through a broad range of clinical symptoms shared with multiple different diseases from the Flaviviridae virus family, causing misdiagnosis to be common with the following diseases:[1]
- Of note, patients bitten by mosquitoes may be concomitantly infected with Zika virus and other mosquito-borne infections, and co-infection should always be considered.
- Zika virus infection is clinically distinct from similar diseases by its typically mild symptoms and short length, with symptoms typically lasting 4-7 days total and not requiring hospitalization.[2]
- Zika virus infection-related complications, such as microcephaly and Guillain-Barré syndrome, distinguish Zika virus infection from other Flaviviridae Virus diseases.[3]
Differentiating Zika Fever from Dengue Fever
The following table summarizes the distinguishing and common features between Zika fever and Dengue fever, both of which are transmitted by the Aedes mosquito:
| Dengue Fever | Zika Fever | |
| Common Clinical Features | Biphasic fever pattern, maculopapular rash, arthralgia, headache, and signs of hemorrhage | Fever, maculopapular rash, conjunctivitis, and headache |
| Hemorrhage Common? | Yes | No |
| Symptom Severity | May be severe | Usually mild |
| Symptom Duration | 2 to 7 days | 4 to 7 days |
| Incubation Period | 4 to 10 days | 3 to 12 days |
| Endemicity | Americas, Africa, Southeast Asia | Americas, Africa, Southeast Asia |
| Vector | Aedes mosquito | Aedes mosquito |
| Laboratory Findings | Leucopenia, rising hematocrit (suggestive of impending hemorrhage), thrombocytopenia, elevated liver function tests | Leucopenia but normal hematocrit, platelet count, and liver function tests |
| Diagnosis | RT-PCR or ELISA | RT-PCR or ELISA |
| Treatment | Supportive care, avoid aspirin and other NSAIDs | Supportive care |
References
- ↑ Zika virus. Center for Disease Control and Prevention for Medical Professionals. http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html Accessed on December 10, 2015
- ↑ Outbreak of Exanthematous Illness Associated with Zika, Chikungunya, and Dengue Viruses, Salvador, Brazil. Emerging Infectious Diseases; Center for Disease Control. http://wwwnc.cdc.gov/eid/pdfs/vol21no12_pdf-version.pdf Accessed on December 16, 2015
- ↑ "Epidemiological Alert: Neurological Syndromes, Congenital Malformations, and Zika Virus Infection. Implications for Public Health in the Americas". Pan American Health Organization. Pan American Health Organization. December 1, 2015. Retrieved December 11, 2015.