Relapsing fever differential diagnosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differentiating Relapsing fever from other Diseases
The following infectious diseases should be considered in someone with recurrent episodes of a febrile illness:
- Colorado tick fever
- Infectious mononucleosis
- Ascending (intermittent) cholangitis
- Yellow fever
- African hemorrhagic fevers
- Lymphocytic choriomengitis
- Dengue fever
- Leptospirosis
- Infections with echovirus 9
- Malaria
- Chronic meningococcemia
- Infections with Bartonella species
- Brucellosis
- Rat bite fever.[1]
| Disease | Organism | Vector | Symptoms | |
|---|---|---|---|---|
| Bacterial Infection | ||||
| Borreliosis (Lyme Disease) [2] | Borrelia burgdorferi sensu lato complex and B. mayonii | I. scapularis, I. pacificus, I. ricinus, and I. persulcatus | Erythema migrans, flu-like illness(fatigue, fever), Lyme arthritis, neuroborreliosis, and carditis. | |
| Relapsing Fever [3] | Tick-borne relapsing fever (TBRF): | Borrelia duttoni, Borrelia hermsii, and Borrelia parkerii | Ornithodoros species | Consistently documented high fevers, flu-like illness, headaches, muscular soreness or joint pain, altered mental status, painful urination, rash, and rigors. |
| Louse-borne relapsing fever (LBRF) : | Borrelia recurrentis | Pediculus humanus | ||
| Typhus (Rickettsia) | ||||
| Rocky Mountain Spotted Fever | Rickettsia rickettsii | Dermacentor variabilis, Dermacentor andersoni | Fever, altered mental status, myalgia, rash, and headaches. | |
| Helvetica Spotted Fever [4] | Rickettsia helvetica | Ixodes ricinus | Rash: spotted, red dots. Respiratory symptoms (dyspnea, cough), muscle pain, and headaches. | |
| Ehrlichiosis (Anaplasmosis) [5] | Ehrlichia chaffeensis, Ehrlichia ewingii | Amblyomma americanum, Ixodes scapularis | Fever, headache, chills, malaise, muscle pain, nausea, confusion, conjunctivitis, or rash (60% in children and 30% in adults). | |
| Tularemia [6] | Francisella tularensis | Dermacentor andersoni, Dermacentor variabilis | Ulceroglandular, glandular, oculoglandular, oroglandular, pneumonic, typhoidal. | |
| Viral Infection | ||||
| Tick-borne meningoencephalitis [7] | TBEV virus | Ixodes scapularis, I. ricinus, I. persulcatus | Early Phase: Non-specific symptoms including fever, malaise, anorexia, muscle pains, headaches, nausea, and vomiting. Second Phase: Meningitis symptoms, headache, stiff neck, encephalitis, drowsiness, sensory disturbances, and potential paralysis. | |
| Colorado Tick Fever [8] | CTF virus | Dermacentor andersoni | Common symptoms include fever, chills, headache, body aches, and lethargy. Other symptoms associated with the disease include sore throat, abdominal pain, vomiting, and a skin rash. A biphasic fever is a hallmark of Colorado Tick Fever and presents in nearly 50% of infected patients. | |
| Crimean-Congo Hemorrhagic Fever | CCHF virus | Hyalomma marginatum, Rhipicephalus bursa | Initially infected patients will likely feel a few of the following symptoms: headache, high fever, back and joint pain, stomach pain, vomiting, flushed face, red throat petechiae of the palate, and potentially changes in mood as well as sensory perception. | |
| Protozoan Infection | ||||
| Babesiosis [9] | Babesia microti, Babesia divergens, Babesia equi | Ixodes scapularis, I. pacificus | Non-specific flu-like symptoms. | |
References
- ↑ http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_Symptoms.htmhttp://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_LabAnalysis.htm
- ↑ Lyme Disease Information for HealthCare Professionals. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/lyme/healthcare/index.html Accessed on December 30, 2015
- ↑ Relapsing Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/relapsing-fever/ Accessed on December 30, 2015
- ↑ Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015
- ↑ Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015
- ↑ Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015
- ↑ General Disease Information (TBE). Centers for Disease Control and Prevention (2015). http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015
- ↑ General Tick Deisease Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/coloradotickfever/index.html Accessed on December 30, 2015
- ↑ Babesiosis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/parasites/babesiosis/disease.htmlAccessed December 8, 2015.