Tick-borne encephalitis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ilan Dock, B.S.
Overview
Tick-borne encephalitis must be differentiated form other tick-borne diseases as well as infections induced by the different subtypes of tick-borne encephalitis virus (TBEV). TBEV also shares a common disease vector with many other tick-borne diseases, therefore a healthcare provider must recognize the potential for multiple co-infections. Found below are tables outlining the clinical manifestations of TBEV subtypes as well as commonly transmitted tick-borne diseases.
Differentiating between infections among TBEV subtypes
- Three subtypes of tick-borne encephalitis are commonly responsible for infection. These subtypes and their specific clinical manifestations are outlined in the table below:
| Subtype | Clinical manifestations |
|---|---|
| Siberian[1] |
|
| Far Eastern[1] |
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| European[1] |
|
Differentiating between tick-borne encephalitis and other tick-borne diseases
- Disease vectors responsible for the transmission of tick-borne encephalitis are commonly carriers of other tick-borne diseases. Therefore due to this common disease vector, a healthcare provider must recognize all potential co-infections. A healthcare provider must also be able to distinguish between the different tick-borne diseases and TBEV. Found below is a table of tick-borne diseases, including TBEV, and their typical clinical manifestations.
| Disease | Symptoms |
|---|---|
| Tick-borne meningoencephalitis[2] | 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. |
| Bacterial Infection | |
| Borreliosis (Lyme Disease)[3] | Flu-like illness, fatigue, fever, arthritis, neuroborreliosis, cranial nerve palsy, carditis and erythema migrans. |
| Relapsing Fever[4] | Consistently documented high fevers, 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[5] | Rash: spotted, red dots. Respiratory symptoms (dyspnea, cough), muscle pain, and headaches. |
| Ehrlichiosis Anaplasmosis[6] | Fever, headache, chills, malaise, muscle pain, nausea, confusion, conjunctivitis, or rash (60% in children and 30% in adults). |
| Tularemia[7] | Ulceroglandular, Glandular, Oculoglandular, Oroglandular, Pneumonic, Typhoidal. |
| Viral Infection | |
| Colorado Tick Fever[8] | 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. |
| Protozoan Infection | |
| Babesiosis[9] | Non-specific flu like symptoms. |
References
- ↑ 1.0 1.1 1.2 Tick-borne Encephalitis Virus: A General Overview. http://cdn.intechopen.com/pdfs-wm/20866.pdf. Accessed February 4, 2016.
- ↑ General Disease Information (TBE). Centers for Disease Control and Prevention (2015). http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015
- ↑ 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 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.