Bourbon virus infection differential diagnosis

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

Overview

Bourbon virus infection must be differentiated from other diseases that may cause arthralgia, fever, and skin manifestations with the history of exposure to ticks. The differential diagnosis of Bourbon virus disease includes Lyme disease, ehrlichiosis, anaplasmosis, Rocky Mountain spotted fever, leptospirosis, and influenza.

Differentiating Bourbon Virus Infection from other diseases

Bourbon virus infection must be differentiated from other diseases that may cause arthralgia, fever, history of tick exposure, and skin manifestations. The differential diagnosis of Bourbon virus disease includes Lyme disease, ehrlichiosis, anaplasmosis, Rocky Mountain spotted fever, leptospirosis, and influenza.

Disease Symptoms
Bacterial Infection
Borreliosis (Lyme Disease) [1] Flu-like illness, fatigue, fever, arthritis, neuroborreliosis, cranial nerve palsy, carditis and erythema migrans.
Relapsing Fever [2] Consistently documented highfevers, flu-like illness, headaches, muscular soreness or joint pain, altered mental state, painful urination, rash, and rigors.
Typhus (Rickettsia)
Rocky Mountain Spotted Fever Fever, alterations in mental state, myalgia, rash, and headaches.
Helvetica Spotted Fever [3] Rash: spotted, red dots. Respiratory symptoms (dyspnea, cough), muscle pain, and headaches.
Ehrlichiosis Anaplasmosis [4] Fever, headache, chills, malaise, muscle pain, nausea, confusion, conjunctivitis, or rash(60% in children and 30% in adults).
Tularemia [5] Ulceroglandular, Glandular, Oculoglandular, Oroglandular, Pneumonic, Typhoidal.
Viral Infection
Tick-borne meningoencephalitis [6] 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 [7] 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 itself in nearly 50% of infected patients.
Crimean-Congo Hemorrhagic Fever 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.
Heartland virus disease [8] Fever, fatigue, anorexia, nausea, or diarrhea. Patients also have leukopenia, thrombocytopenia, and mildly to moderately elevated liver transaminases.
Bourbon virus disease [9] Fever, fatigue, anorexia, nausea, vomiting, and maculopapular rash. Patients are also found to have thrombocytopenia and leukopenia.
Protozoan Infection
Babesiosis [10] Non-specific flu like symptoms.

References

  1. 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
  2. Relapsing Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/relapsing-fever/ Accessed on December 30, 2015
  3. Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015
  4. Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015
  5. Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015
  6. General Disease Information (TBE). Centers for Disease Control and Prevention (2015). http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015
  7. General Tick Deisease Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/coloradotickfever/index.html Accessed on December 30, 2015
  8. "CDC - Heartland virus (a phlebovirus) - Division of Vector-Borne Diseases (DVBD) - NCEZID".
  9. "Bourbon virus | Division of Vector-Borne Diseases (DVBD) | NCEZID | CDC".
  10. Babesiosis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/parasites/babesiosis/disease.htmlAccessed December 8, 2015.

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