St. Louis encephalitis differential diagnosis: Difference between revisions
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{{St. Louis encephalitis}} | {{St. Louis encephalitis}} | ||
{{CMG}} {{AE}} | {{CMG}} {{AE}} {{AG}} | ||
==Overview== | |||
St. Louis encephalitis must be differentiated from other diseases that cause nondescript symptoms, which include [[fever]], [[headache]], [[myalgia]], [[vomiting]], such as other [[vector-borne encephalitis]] diseases, [[malaria]], and [[primary central nervous system lymphoma]]. | |||
==Differentiating St. Louis encephalitis from Other Diseases== | |||
Japanese encephalitis must be differentiated from other diseases that cause [[fever]], [[headache]], [[myalgia]], and [[vomiting]], such as:<ref name=Mandell1> M.D. JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Expert Consult Premium Edition. Saunders; 2014.</ref><ref name="pmid14978145">{{cite journal| author=Kennedy PG| title=Viral encephalitis: causes, differential diagnosis, and management. | journal=J Neurol Neurosurg Psychiatry | year= 2004 | volume= 75 Suppl 1 | issue= | pages= i10-5 | pmid=14978145 | doi= | pmc=PMC1765650 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14978145 }} </ref><ref name=NYDeptofHealth> Arboviral Infections (arthropod-borne encephalitis, eastern equine encephalitis, St. Louis encephalitis, California encephalitis, Powassan encephalitis, West Nile encephalitis). New York State Department of Health (2006). https://www.health.ny.gov/diseases/communicable/arboviral/fact_sheet.htm Accessed on February 23, 2016 </ref><ref name="pmid21932127">{{cite journal| author=Eckstein C, Saidha S, Levy M| title=A differential diagnosis of central nervous system demyelination: beyond multiple sclerosis. | journal=J Neurol | year= 2012 | volume= 259 | issue= 5 | pages= 801-16 | pmid=21932127 | doi=10.1007/s00415-011-6240-5 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21932127 }} </ref><ref name="pmid11260760">{{cite journal| author=De Kruijk JR, Twijnstra A, Leffers P| title=Diagnostic criteria and differential diagnosis of mild traumatic brain injury. | journal=Brain Inj | year= 2001 | volume= 15 | issue= 2 | pages= 99-106 | pmid=11260760 | doi=10.1080/026990501458335 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11260760 }} </ref> | |||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | |||
|+ | |||
! style="background: #4479BA; width: 50px;" | {{fontcolor|#FFF|Disease}} | |||
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Similarities}} | |||
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Differentials}} | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Meningitis]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Classic triad of [[fever]], [[nuchal rigidity]], and [[altered mental status]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" |[[Photophobia]], [[phonophobia]], [[rash]] associated with [[meningococcemia]], concomitant [[sinusitis]] or [[otitis]], swelling of the [[fontanelle]] in infants (0-6 months) | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Brain abscess]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Fever]], [[headache]], [[hemiparesis]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Varies depending on the location of the abscess; clinically, [[visual disturbance]] including [[papilledema]], decreased [[sensation]]; on imaging, a [[lesion]] demonstrates both ring enhancement and central restricted diffusion | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Demyelinating disease]]s''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Ataxia]], [[lethargy]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" |[[Multiple sclerosis]]: clinically, [[nystagmus]], [[internuclear ophthalmoplegia]], [[Lhermitte's sign]]; on imaging, well-demarcated ovoid lesions with possible T1 hypointensities (“black holes”) | |||
[[Acute disseminated encephalomyelitis]]: ; on imaging, diffuse or multi-lesion enhancement, with indistinct lesion borders | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Substance abuse]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Tremor]], [[headache]], [[altered mental status]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Varies depending on type of substance: prior history, drug-seeking behavior, attention-seeking behavior, [[paranoia]], sudden [[panic]], [[anxiety]], [[hallucination]]s | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Electrolyte disturbance]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Fatigue]], [[headache]], [[nausea]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Varies depending on deficient ions; clinically, [[edema]], [[constipation]], [[hallucination]]s; on [[EKG]], abnormalities in [[T wave]], [[P wave]], [[QRS complex]]; possible presentations include [[arrhythmia]], [[dehydration]], [[renal failure]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Stroke]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Ataxia]], [[aphasia]], [[dizziness]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" |Varies depending on classification of stroke; presents with positional [[vertigo]], high [[blood pressure]], [[extremities|extremity]] weakness | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Intracranial hemorrhage]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Headache]], [[coma]], [[dizziness]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Lobar [[hemorrhage]], [[numbness]], [[tingling]], [[hypertension]], [[hemorrhagic diathesis]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Trauma]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Headache]], [[altered mental status]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Amnesia]], [[loss of consciousness]], [[dizziness]], [[concussion]], [[contusion]] | |||
|- | |||
|} | |||
==References== | ==References== | ||
Revision as of 15:16, 3 May 2016
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St. Louis encephalitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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St. Louis encephalitis differential diagnosis On the Web |
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American Roentgen Ray Society Images of St. Louis encephalitis differential diagnosis |
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Risk calculators and risk factors for St. Louis encephalitis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anthony Gallo, B.S. [2]
Overview
St. Louis encephalitis must be differentiated from other diseases that cause nondescript symptoms, which include fever, headache, myalgia, vomiting, such as other vector-borne encephalitis diseases, malaria, and primary central nervous system lymphoma.
Differentiating St. Louis encephalitis from Other Diseases
Japanese encephalitis must be differentiated from other diseases that cause fever, headache, myalgia, and vomiting, such as:[1][2][3][4][5]
| Disease | Similarities | Differentials |
|---|---|---|
| Meningitis | Classic triad of fever, nuchal rigidity, and altered mental status | Photophobia, phonophobia, rash associated with meningococcemia, concomitant sinusitis or otitis, swelling of the fontanelle in infants (0-6 months) |
| Brain abscess | Fever, headache, hemiparesis | Varies depending on the location of the abscess; clinically, visual disturbance including papilledema, decreased sensation; on imaging, a lesion demonstrates both ring enhancement and central restricted diffusion |
| Demyelinating diseases | Ataxia, lethargy | Multiple sclerosis: clinically, nystagmus, internuclear ophthalmoplegia, Lhermitte's sign; on imaging, well-demarcated ovoid lesions with possible T1 hypointensities (“black holes”)
Acute disseminated encephalomyelitis: ; on imaging, diffuse or multi-lesion enhancement, with indistinct lesion borders |
| Substance abuse | Tremor, headache, altered mental status | Varies depending on type of substance: prior history, drug-seeking behavior, attention-seeking behavior, paranoia, sudden panic, anxiety, hallucinations |
| Electrolyte disturbance | Fatigue, headache, nausea | Varies depending on deficient ions; clinically, edema, constipation, hallucinations; on EKG, abnormalities in T wave, P wave, QRS complex; possible presentations include arrhythmia, dehydration, renal failure |
| Stroke | Ataxia, aphasia, dizziness | Varies depending on classification of stroke; presents with positional vertigo, high blood pressure, extremity weakness |
| Intracranial hemorrhage | Headache, coma, dizziness | Lobar hemorrhage, numbness, tingling, hypertension, hemorrhagic diathesis |
| Trauma | Headache, altered mental status | Amnesia, loss of consciousness, dizziness, concussion, contusion |
References
- ↑ M.D. JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Expert Consult Premium Edition. Saunders; 2014.
- ↑ Kennedy PG (2004). "Viral encephalitis: causes, differential diagnosis, and management". J Neurol Neurosurg Psychiatry. 75 Suppl 1: i10–5. PMC 1765650. PMID 14978145.
- ↑ Arboviral Infections (arthropod-borne encephalitis, eastern equine encephalitis, St. Louis encephalitis, California encephalitis, Powassan encephalitis, West Nile encephalitis). New York State Department of Health (2006). https://www.health.ny.gov/diseases/communicable/arboviral/fact_sheet.htm Accessed on February 23, 2016
- ↑ Eckstein C, Saidha S, Levy M (2012). "A differential diagnosis of central nervous system demyelination: beyond multiple sclerosis". J Neurol. 259 (5): 801–16. doi:10.1007/s00415-011-6240-5. PMID 21932127.
- ↑ De Kruijk JR, Twijnstra A, Leffers P (2001). "Diagnostic criteria and differential diagnosis of mild traumatic brain injury". Brain Inj. 15 (2): 99–106. doi:10.1080/026990501458335. PMID 11260760.