Non-Polio enterovirus infections differential diagnosis: Difference between revisions
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!Additional findings | !Additional findings | ||
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|'''Influenza''' | |'''Influenza''' <ref name="pmid29083802">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=29083802 | doi= | pmc= | url= }}</ref> | ||
|Cough, fever, sore throat, headache, myalgia, runny nose, congested eyes | |Cough, fever, sore throat, headache, myalgia, runny nose, congested eyes | ||
|Chest X-ray may show signs of concomitant bacterial pneumonia | |Chest X-ray may show signs of concomitant bacterial pneumonia | ||
| Line 20: | Line 20: | ||
|Frontal or retro-orbital headache, photophobia, ocular pain, shortness of breath, tachycardia, hypotension and need for ventilation in severe cases | |Frontal or retro-orbital headache, photophobia, ocular pain, shortness of breath, tachycardia, hypotension and need for ventilation in severe cases | ||
|- | |- | ||
|'''Adenovirus infection''' | |'''Adenovirus infection''' <ref name="pmid27486739">{{cite journal| author=Lynch JP, Kajon AE| title=Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention. | journal=Semin Respir Crit Care Med | year= 2016 | volume= 37 | issue= 4 | pages= 586-602 | pmid=27486739 | doi=10.1055/s-0036-1584923 | pmc=7171713 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27486739 }}</ref> | ||
| | |Fever, pharyngitis, coryza, watery eyes | ||
| | |Cervical adenopathy, pharyngoconjunctivitis, tonsillitis | ||
| | |Viral culture, PCR. viral antigen assay, serology | ||
| | |Dyspnea, gross bloody urine | ||
|- | |- | ||
|'''Bacterial pharyngitis, sinusitis''' | |'''Bacterial pharyngitis, sinusitis'''<ref name="pmid23958368">{{cite journal| author=Grief SN| title=Upper respiratory infections. | journal=Prim Care | year= 2013 | volume= 40 | issue= 3 | pages= 757-70 | pmid=23958368 | doi=10.1016/j.pop.2013.06.004 | pmc=7127764 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23958368 }}</ref> | ||
| | |Purulent nasal discharge, maxillary tooth or facial pain, worsening after initial improvement (fever, headache, increase in nasal discharge) | ||
| | |Unilateral maxillary sinus tenderness, pharyngeal erythema and swelling, tonsillar exudates, edematous uvula, palatine petechiae, anterior cervical lymphadenopathy | ||
| | |Nasal endoscopy or antral puncture and culture of secretions, Centor criteria | ||
| | |Ear pain/pressure/fullness, sore throat, halitosis, cough, fatigue, rheumatic fever, peritonsillar abscess, post-streptococcal glomerulonephritis and scarlet fever | ||
|- | |- | ||
|'''Allergic rhinitis''' | |'''Allergic rhinitis''' | ||
| | |Sneezing, rhinorrhoea, watery eyes, postnasal drip, chronic nasal congestion and obstruction<ref name="pmid26075169">{{cite journal| author=Varshney J, Varshney H| title=Allergic Rhinitis: an Overview. | journal=Indian J Otolaryngol Head Neck Surg | year= 2015 | volume= 67 | issue= 2 | pages= 143-9 | pmid=26075169 | doi=10.1007/s12070-015-0828-5 | pmc=4460099 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26075169 }}</ref>, triggers like pollen, animal dander, flooring/upholstery, molds, humidity, perfumes and/or tobacco smoke<ref name="pmid22166009">{{cite journal| author=Small P, Kim H| title=Allergic rhinitis. | journal=Allergy Asthma Clin Immunol | year= 2011 | volume= 7 Suppl 1 | issue= Suppl 1 | pages= S3 | pmid=22166009 | doi=10.1186/1710-1492-7-S1-S3 | pmc=3245436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22166009 }}</ref> | ||
| | |Mouth breathing, frequent sniffling/throat clearing, transverse supra-tip nasal crease and dark circles under the eyes. Swelling of the nasal mucosa and thin,clear secretions on anterior rhinoscopy<ref name="pmid221660092">{{cite journal| author=Small P, Kim H| title=Allergic rhinitis. | journal=Allergy Asthma Clin Immunol | year= 2011 | volume= 7 Suppl 1 | issue= Suppl 1 | pages= S3 | pmid=22166009 | doi=10.1186/1710-1492-7-S1-S3 | pmc=3245436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22166009 }}</ref> | ||
| | |Serum testing for allergen-specific IgE or allergy skin testing<ref name="pmid25629743">{{cite journal| author=Wheatley LM, Togias A| title=Clinical practice. Allergic rhinitis. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 5 | pages= 456-63 | pmid=25629743 | doi=10.1056/NEJMcp1412282 | pmc=4324099 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25629743 }}</ref> | ||
| | |Bluish hue of inferior turbinates, cobblestoning of the nasal mucosa, nasal polyps, eustachian tube dysfunction, allergic dermatitis, aspirin sensitivity, tender sinuses<ref name="pmid221660093">{{cite journal| author=Small P, Kim H| title=Allergic rhinitis. | journal=Allergy Asthma Clin Immunol | year= 2011 | volume= 7 Suppl 1 | issue= Suppl 1 | pages= S3 | pmid=22166009 | doi=10.1186/1710-1492-7-S1-S3 | pmc=3245436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22166009 }}</ref> | ||
|} | |} | ||
Revision as of 16:28, 6 February 2023
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Overview
Differential diagnoses
Differential diagnoses for rhinovirus
| Disease | Clinical Findings | Para-clinical findings | Gold standard | Additional findings |
|---|---|---|---|---|
| Influenza [1] | Cough, fever, sore throat, headache, myalgia, runny nose, congested eyes | Chest X-ray may show signs of concomitant bacterial pneumonia | Immunofluorescent direct and indirect antibody staining for detection of viral antigen, real-time PCR test, cell culture of upper or lower respiratory tract specimens | Frontal or retro-orbital headache, photophobia, ocular pain, shortness of breath, tachycardia, hypotension and need for ventilation in severe cases |
| Adenovirus infection [2] | Fever, pharyngitis, coryza, watery eyes | Cervical adenopathy, pharyngoconjunctivitis, tonsillitis | Viral culture, PCR. viral antigen assay, serology | Dyspnea, gross bloody urine |
| Bacterial pharyngitis, sinusitis[3] | Purulent nasal discharge, maxillary tooth or facial pain, worsening after initial improvement (fever, headache, increase in nasal discharge) | Unilateral maxillary sinus tenderness, pharyngeal erythema and swelling, tonsillar exudates, edematous uvula, palatine petechiae, anterior cervical lymphadenopathy | Nasal endoscopy or antral puncture and culture of secretions, Centor criteria | Ear pain/pressure/fullness, sore throat, halitosis, cough, fatigue, rheumatic fever, peritonsillar abscess, post-streptococcal glomerulonephritis and scarlet fever |
| Allergic rhinitis | Sneezing, rhinorrhoea, watery eyes, postnasal drip, chronic nasal congestion and obstruction[4], triggers like pollen, animal dander, flooring/upholstery, molds, humidity, perfumes and/or tobacco smoke[5] | Mouth breathing, frequent sniffling/throat clearing, transverse supra-tip nasal crease and dark circles under the eyes. Swelling of the nasal mucosa and thin,clear secretions on anterior rhinoscopy[6] | Serum testing for allergen-specific IgE or allergy skin testing[7] | Bluish hue of inferior turbinates, cobblestoning of the nasal mucosa, nasal polyps, eustachian tube dysfunction, allergic dermatitis, aspirin sensitivity, tender sinuses[8] |
References
- ↑ "StatPearls". 2022. PMID 29083802.
- ↑ Lynch JP, Kajon AE (2016). "Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention". Semin Respir Crit Care Med. 37 (4): 586–602. doi:10.1055/s-0036-1584923. PMC 7171713 Check
|pmc=value (help). PMID 27486739. - ↑ Grief SN (2013). "Upper respiratory infections". Prim Care. 40 (3): 757–70. doi:10.1016/j.pop.2013.06.004. PMC 7127764 Check
|pmc=value (help). PMID 23958368. - ↑ Varshney J, Varshney H (2015). "Allergic Rhinitis: an Overview". Indian J Otolaryngol Head Neck Surg. 67 (2): 143–9. doi:10.1007/s12070-015-0828-5. PMC 4460099. PMID 26075169.
- ↑ Small P, Kim H (2011). "Allergic rhinitis". Allergy Asthma Clin Immunol. 7 Suppl 1 (Suppl 1): S3. doi:10.1186/1710-1492-7-S1-S3. PMC 3245436. PMID 22166009.
- ↑ Small P, Kim H (2011). "Allergic rhinitis". Allergy Asthma Clin Immunol. 7 Suppl 1 (Suppl 1): S3. doi:10.1186/1710-1492-7-S1-S3. PMC 3245436. PMID 22166009.
- ↑ Wheatley LM, Togias A (2015). "Clinical practice. Allergic rhinitis". N Engl J Med. 372 (5): 456–63. doi:10.1056/NEJMcp1412282. PMC 4324099. PMID 25629743.
- ↑ Small P, Kim H (2011). "Allergic rhinitis". Allergy Asthma Clin Immunol. 7 Suppl 1 (Suppl 1): S3. doi:10.1186/1710-1492-7-S1-S3. PMC 3245436. PMID 22166009.