West nile virus differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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,

Differential Diagnosis

West Nile Fever

Disease	Findings

Severe West Nile Virus Infection

Disease	Findings
HSV encephalitis	Headache, fever, history of herpes virus infection
Enterovirus encephalitis	Encephalitis symptoms associated with sore throat, diarrhea, skin rash, and altered mental status.
Metabolic and toxic encephalopathy	The majority of patients present with altered mental status, additional findings include signs of uremia, electrolyte disturbances, and history of drug intake or overdose.
Bacterial encephalitis	Patients present with altered mental status, toxic-appearance, fever, CSF findings will include high level of neutrophils, high protein and low glucose levels.
Guillain-Barré syndrome	Often presents with distal, ascending, symmetrical paralysis with abolished reflexes, and it is associated with a recent viral or bacterial gastroenteritis.
Acute Poliomyelitis	Patients may present with flaccid paralysis

References

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