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

Differentiating Japanese encephalitis from Other Diseases

Japanese encephalitis must be differentiated from other diseases that cause fever, headache, and vomiting, such as:[1][2][3]

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.
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.
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.
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.


References

  1. M.D. JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Expert Consult Premium Edition. Saunders; 2014.
  2. Kennedy PG (2004). "Viral encephalitis: causes, differential diagnosis, and management". J Neurol Neurosurg Psychiatry. 75 Suppl 1: i10–5. PMC 1765650. PMID 14978145.
  3. 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