Japanese encephalitis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anthony Gallo, B.S. [2]

Overview

Japanese encephalitis must be differentiated from other diseases that cause nondescript symptoms, which include fever, headache, and vomiting, such as other vector-borne encephalitis diseases, malaria, and primary central nervous system lymphoma.

Differentiating Japanese encephalitis from Other Diseases

Japanese encephalitis must be differentiated from other diseases that cause fever, headache, and vomiting, such as:

Disease	Findings
West Nile encephalitis	West Nile encephalitis presents with acute inflammation of the brain, caused by an arboviral infection; West Nile encephalitis may present with include fever, nausea, headache, stiff neck, photophobia, seizures, and coma.
St. Louis encephalitis	St. Louis encephalitis presents with acute inflammation of the brain, caused by an arboviral infection; St. Louis encephalitis may present with fever, nausea, headache, malaise, photophobia, seizures, and coma.
Other Vector-Borne encephalitis	Vector-borne encephalitis presents with acute inflammation of the brain, caused by a bacterial infection or arboviral infection; complications include severe brain damage as the inflamed brain pushes against the skull, potentially leading to mortality. See also: Tick-borne encephalitis, California encephalitis virus, La Crosse encephalitis, Western equine encephalitis, Eastern equine encephalitis, and Venezuelan equine encephalitis
Viral encephalitis	Viral encephalitis presents with acute inflammation of the brain, caused by a viral infection; complications include severe brain damage as the inflamed brain pushes against the skull, potentially leading to mortality. See also: Herpes simplex encephalitis and VZV encephalitis
Encephalopathy	Encephalopathy presents with steady depression, generalized seizures. Generally absent are fever, headache, leukocytosis, and pleocytosis; MRI often appears normal.
Meningitis	Meningitis presents with headache, altered mental status, and inflammation of the meninges, which may develop in the setting of an infection, physical injury, cancer, or certain drugs; it may have an indolent evolution, resolving on its own, or may present as an rapidly evolving inflammation, causing neurologic damage and possible mortality. See also: Bacterial meningitis, Viral meningitis, and Fungal meningitis
Malaria	Malaria presents with a fever, which commonly occurs in paroxysms, separated by fever-free time intervals. Other symptoms include chills, headache, nausea, vomiting, and weakness.
Primary central nervous system lymphoma	Primary central nervous system lymphoma presents with headache, nausea, monocular vision loss, myalgia, and seizures.