Ebola differential diagnosis: Difference between revisions
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| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Malaria]]''' | | style="padding: 5px 5px; background: #DCDCDC;" |'''[[Malaria]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Presents with acute [[fever]], [[headache]] and sometimes [[diarrhea]] (children). A [[blood smear]]s must be examined for malaria parasites. The presence of [[parasites]] does not exclude a concurrent viral infection. An [[antimalarial]] should be prescribed as an [[empiric therapy]]. Although both Malaria and Ebola virus may present with constitutional symptoms and similar lab abnormalities, Malaria is more likely to involve ''paroxysms'' of fever, hypoglycemia, acute respiratory distress syndrome (ARDS), whereas Ebola virus is more likely to | | style="padding: 5px 5px; background: #F5F5F5;" |Presents with acute [[fever]], [[headache]] and sometimes [[diarrhea]] (children). A [[blood smear]]s must be examined for malaria parasites. The presence of [[parasites]] does not exclude a concurrent viral infection. An [[antimalarial]] should be prescribed as an [[empiric therapy]]. Although both Malaria and Ebola virus may present with constitutional symptoms and similar lab abnormalities, Malaria is more likely to involve ''paroxysms'' of fever, hypoglycemia, acute respiratory distress syndrome (ARDS), whereas Ebola virus is more likely to involve hemorrhagic sequelae.<ref name=Emergency Physicians Review>{{cite journal| author=| title=Ebola virus outbreak 2014: clinical review for emergency physicians | journal=Annals of Emergency Medicine | year= 2014| volume= | issue= | pages= | pmid= | doi= | pmc= | url=http://www.sciencedirect.com/science/article/pii/S0196064414013961 }} </ref> | ||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Lassa fever]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[Lassa fever]]''' | ||
Revision as of 19:53, 27 October 2014
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Ebola differential diagnosis On the Web |
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Risk calculators and risk factors for Ebola differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]; Guillermo Rodriguez Nava, M.D. [3]
Overview
Ebola must be differentiated from other diseases that cause hemorrhage and/or high fever as part of their presentation such as Marburg virus, Lassa fever, Typhoid fever and Malaria. The clinician must first rule out other more common causes of the fever before considering a viral hemorrhagic fever (VHF) such as Ebola, and the consideration of a VHF should be based upon epidemiology and demographics as well as sign and symptoms.[1] A VHF such as Ebola, should be suspected in febrile persons who, within 3 weeks before onset of fever, have either: 1) traveled in the specific local area of a country where VHF has recently occurred; 2) had direct unprotected contact with blood, other body fluids, secretions, or excretions of a person or animal with VHF; 3) if the patient had any contact with someone who was ill with fever and bleeding or who died from an unexplained illness with fever and bleeding; 4) had a possible exposure when working in a laboratory that handles hemorrhagic fever viruses; 5) If a fever continues after 3 days of empiric treatment, and if the patient has signs such as bleeding or shock, the clinician must consider a VHF; 6) if no other cause is found for the patient’s signs and symptoms, the clinician must suspect a VHF.
Differentiating Ebola from other Diseases
The table below summarizes the findings that differentiate Ebola from other conditions that cause fever and hemorrhage:
| Disease | Findings |
|---|---|
| Shigellosis & other bacterial enteric infections | Presents with diarrhea, possibly bloody, accompanied by fever, nausea, and sometimes toxemia, vomiting, cramps, and tenesmus. Stools contain blood and mucous in a typical case. A search for possible sites of bacterial infection, together with cultures and blood smears, should be made. Presence of leucocytosis distinguishes bacterial infections from viral infections. |
| Typhoid fever | Presents with fever, headache, rash, gastrointestinal symptoms, with lymphadenopathy, relative bradycardia, cough and leucopenia and sometimes sore throat. Blood and stool culture can confirm the presence of the causative bacteria. |
| Malaria | Presents with acute fever, headache and sometimes diarrhea (children). A blood smears must be examined for malaria parasites. The presence of parasites does not exclude a concurrent viral infection. An antimalarial should be prescribed as an empiric therapy. Although both Malaria and Ebola virus may present with constitutional symptoms and similar lab abnormalities, Malaria is more likely to involve paroxysms of fever, hypoglycemia, acute respiratory distress syndrome (ARDS), whereas Ebola virus is more likely to involve hemorrhagic sequelae.Invalid parameter in <ref> tag
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| Lassa fever | Disease onset is usually gradual, with fever, sore throat, cough, pharyngitis, and facial edema in the later stages. Inflammation and exudation of the pharynx and conjunctiva are common. |
| Yellow fever and other Flaviviridae | Present with hemorrhagic complications. Epidemiological investigation may reveal a pattern of disease transmission by an insect vector. Virus isolation and serological investigation serves to distinguish these viruses. Confirmed history of previous yellow fever vaccination will rule out yellow fever. |
| Others | Viral hepatitis, leptospirosis, dengue fever, rheumatic fever, typhus, acute leukemia, systemic lupus erythematosus, idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and mononucleosis |
| Table adapted from WHO Guidelines For Epidemic Preparedness And Response: Ebola Haemorrhagic Fever [2] | |