Non-Polio enterovirus infections differential diagnosis: Difference between revisions
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{{Non-Polio enterovirus infections}} | {{Non-Polio enterovirus infections}} | ||
{{CMG}} {{AE}} {{Sujaya}} | |||
==Overview== | |||
The [[differential]] [[diagnoses]] of non-polio [[enterovirus]] [[infections]] spans [[diseases]] affecting the [[respiratory]], [[gastrointestinal]] and [[central nervous systems]]: | |||
* [[Influenza]] | |||
*[[Adenovirus]] | |||
*[[Upper respiratory tract infections]] ([[pharyngitis]], [[sinusitis]]) | |||
*[[Allergic rhinitis]] | |||
*[[Meningitis]] | |||
*[[Gastroenteritis]] | |||
==Differential [[diagnoses]]== | |||
===Differential [[diagnoses]] for [[rhinovirus]]=== | |||
{| class="wikitable" | |||
|+ | |||
![[Disease]] | |||
![[Clinical]] Findings | |||
![[Para-clinical]] findings | |||
![[Gold standard]] | |||
!Additional findings | |||
|- | |||
|'''[[Influenza]]''' <ref name="pmid29083802">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=29083802 | doi= | pmc= | url= }}</ref> | |||
|[[Cough]], [[fever]], [[sore throat]], [[headache]], [[myalgia]], [[runny nose]], [[congested]] [[eyes]] | |||
|[[Chest X-ray]] may show signs of concomitant [[bacterial]] [[pneumonia]] | |||
|[[Immunofluorescent]] direct and indirect [[antibody]] staining for detection of [[viral antigen]], real-time [[PCR]] test, [[cell culture]] of upper or lower [[respiratory tract]] specimens | |||
|[[Frontal]] or [[retro-orbital]] [[headache]], [[photophobia]], [[ocular pain]], [[shortness of breath]], [[tachycardia]], [[hypotension]] and need for [[ventilation]] in severe cases | |||
|- | |||
|'''[[Adenovirus infection]]''' <ref name="pmid27486739">{{cite journal| author=Lynch JP, Kajon AE| title=Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention. | journal=Semin Respir Crit Care Med | year= 2016 | volume= 37 | issue= 4 | pages= 586-602 | pmid=27486739 | doi=10.1055/s-0036-1584923 | pmc=7171713 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27486739 }}</ref> | |||
|[[Fever]], [[pharyngitis]], [[coryza]], watery eyes | |||
|[[Cervical]] [[adenopathy]], [[pharyngoconjunctivitis]], [[tonsillitis]] | |||
|[[Viral culture]], [[PCR]], [[viral antigen]] assay, [[serology]] | |||
|[[Dyspnea]], gross [[bloody urine]] | |||
|- | |||
|'''[[Bacterial]] [[pharyngitis]], [[sinusitis]]'''<ref name="pmid23958368">{{cite journal| author=Grief SN| title=Upper respiratory infections. | journal=Prim Care | year= 2013 | volume= 40 | issue= 3 | pages= 757-70 | pmid=23958368 | doi=10.1016/j.pop.2013.06.004 | pmc=7127764 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23958368 }}</ref> | |||
|[[Purulent]] [[nasal]] [[discharge]], [[maxillary]] tooth or facial [[pain]], worsening after initial improvement ([[fever]], [[headache]], increase in [[nasal]] [[discharge]]) | |||
|[[Unilateral]] [[maxillary sinus]] [[tenderness]], [[pharyngeal erythema]] and [[swelling]], [[tonsillar exudates]], [[edematous]] [[uvula]], [[palatine]] [[petechiae]], anterior [[cervical lymphadenopathy]] | |||
|[[Nasal endoscopy]] or [[antral puncture]] and culture of [[secretions]], [[Centor]] criteria | |||
|Ear [[pain]]/pressure/fullness, [[sore throat]], [[halitosis]], [[cough]], [[fatigue]], [[rheumatic fever]], [[peritonsillar abscess]], [[post-streptococcal glomerulonephritis]] and [[scarlet fever]] | |||
|- | |||
|'''[[Allergic rhinitis]]''' | |||
|[[Sneezing]], [[rhinorrhoea]], watery eyes, [[postnasal drip]], [[chronic nasal congestion]] and obstruction<ref name="pmid26075169">{{cite journal| author=Varshney J, Varshney H| title=Allergic Rhinitis: an Overview. | journal=Indian J Otolaryngol Head Neck Surg | year= 2015 | volume= 67 | issue= 2 | pages= 143-9 | pmid=26075169 | doi=10.1007/s12070-015-0828-5 | pmc=4460099 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26075169 }}</ref>, triggers like [[pollen]], [[animal dander]], [[flooring/upholstery]], [[molds]], [[humidity]], perfumes and/or tobacco smoke<ref name="pmid22166009">{{cite journal| author=Small P, Kim H| title=Allergic rhinitis. | journal=Allergy Asthma Clin Immunol | year= 2011 | volume= 7 Suppl 1 | issue= Suppl 1 | pages= S3 | pmid=22166009 | doi=10.1186/1710-1492-7-S1-S3 | pmc=3245436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22166009 }}</ref> | |||
|Mouth breathing, frequent sniffling/throat clearing, transverse supra-tip nasal crease and dark circles under the eyes. Swelling of the nasal mucosa and thin,clear secretions on anterior rhinoscopy<ref name="pmid221660092">{{cite journal| author=Small P, Kim H| title=Allergic rhinitis. | journal=Allergy Asthma Clin Immunol | year= 2011 | volume= 7 Suppl 1 | issue= Suppl 1 | pages= S3 | pmid=22166009 | doi=10.1186/1710-1492-7-S1-S3 | pmc=3245436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22166009 }}</ref> | |||
|[[Serum]] testing for [[allergen-specific]] [[IgE]] or [[allergy]] skin testing<ref name="pmid25629743">{{cite journal| author=Wheatley LM, Togias A| title=Clinical practice. Allergic rhinitis. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 5 | pages= 456-63 | pmid=25629743 | doi=10.1056/NEJMcp1412282 | pmc=4324099 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25629743 }}</ref> | |||
|Bluish hue of [[inferior turbinates]], cobblestoning of the [[nasal mucosa]], [[nasal polyps]], [[eustachian tube]] dysfunction, [[allergic dermatitis]], [[aspirin]] sensitivity, tender sinuses<ref name="pmid221660093">{{cite journal| author=Small P, Kim H| title=Allergic rhinitis. | journal=Allergy Asthma Clin Immunol | year= 2011 | volume= 7 Suppl 1 | issue= Suppl 1 | pages= S3 | pmid=22166009 | doi=10.1186/1710-1492-7-S1-S3 | pmc=3245436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22166009 }}</ref> | |||
|} | |||
===Differential [[diagnoses]] of [[non-rhinovirus]] [[non-polio]] [[enterovirus]] [[infections]]=== | |||
{| class="wikitable" | |||
|+ | |||
!'''Disease''' | |||
!'''Clinical findings''' | |||
!Para-clinical findings | |||
!Gold standard | |||
!Additional findings | |||
|- | |||
|'''[[Meningitis]]'''<ref name="pmid29083833">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=29083833 | doi= | pmc= | url= }}</ref> | |||
|[[Fever]], [[neck pain]], [[stiffness]], [[photophobia]], altered mental status, [[neurological]] deficits, [[seizures]], [[Brudzinski]] and [[Kernig]] signs of [[meningeal]] [[irritation]], | |||
|[[Cerebrospinal fluid]] analysis reveals elevated [[opening pressures]], increased [[White cell count]] and [[protein]].[[Glucose]] is typically normal in [[viral]] and [[fungal]] [[meningitis]]. [[CT]] head for signs of [[raised intracranial pressure]] and/or [[brain herniation]] before [[lumbar puncture]] | |||
|Analysis of [[cerebrospinal fluid]] ([[CSF]]) including [[cultures]], [[serology]] and [[microscopy]] | |||
|[[Headache]], [[dizziness]], [[confusion]], [[delirium]], [[irritability]], [[nausea/vomiting]], [[petechiae]]/[[purpura]] in [[meningococcal]] [[meningitis]], [[cranial nerve]] abnormalities; [[hypothermia]], decreased oral intake, [[irritability]] and [[bulging fontanelle]] in infants | |||
|- | |||
|'''[[Gastroenteritis]]'''<ref name="pmid23958366">{{cite journal| author=Graves NS| title=Acute gastroenteritis. | journal=Prim Care | year= 2013 | volume= 40 | issue= 3 | pages= 727-41 | pmid=23958366 | doi=10.1016/j.pop.2013.05.006 | pmc=7119329 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23958366 }}</ref> | |||
|[[Malaise]], [[anorexia]], [[abdominal pain]] and [[cramping]], [[watery diarrhea]], [[nausea and vomiting]], [[low-grade fever]], signs of [[dehydration]] (dry [[mucous membranes]], [[tachycardia]], [[orthostatic blood pressure]], | |||
|[[Sorbitol]] [[McConkey]] [[agar]] for [[E.coli]] O157:H7 | |||
|Mostly [[clinical]] [[diagnosis]]; [[stool]] for [[ova]], [[parasites]] and [[cultures]], [[fecal]] [[leukocytes]] and [[occult blood]], [[toxin]] [[assays]] | |||
|[[Colitis]], [[bloody diarrhea]], [[tenesmus]], [[hemolytic uremic syndrome]], [[reactive arthritis]], [[Guillain-Barre syndrome]] | |||
|} | |||
== References == | == References == | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Viruses]] | [[Category:Viruses]] |
Latest revision as of 17:50, 6 February 2023
Non-Polio enterovirus infections Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
The differential diagnoses of non-polio enterovirus infections spans diseases affecting the respiratory, gastrointestinal and central nervous systems:
- Influenza
- Adenovirus
- Upper respiratory tract infections (pharyngitis, sinusitis)
- Allergic rhinitis
- Meningitis
- Gastroenteritis
Differential diagnoses
Differential diagnoses for rhinovirus
Differential diagnoses of non-rhinovirus non-polio enterovirus infections
References
- ↑ "StatPearls". 2022. PMID 29083802.
- ↑ Lynch JP, Kajon AE (2016). "Adenovirus: Epidemiology, Global Spread of Novel Serotypes, and Advances in Treatment and Prevention". Semin Respir Crit Care Med. 37 (4): 586–602. doi:10.1055/s-0036-1584923. PMC 7171713 Check
|pmc=
value (help). PMID 27486739. - ↑ Grief SN (2013). "Upper respiratory infections". Prim Care. 40 (3): 757–70. doi:10.1016/j.pop.2013.06.004. PMC 7127764 Check
|pmc=
value (help). PMID 23958368. - ↑ Varshney J, Varshney H (2015). "Allergic Rhinitis: an Overview". Indian J Otolaryngol Head Neck Surg. 67 (2): 143–9. doi:10.1007/s12070-015-0828-5. PMC 4460099. PMID 26075169.
- ↑ Small P, Kim H (2011). "Allergic rhinitis". Allergy Asthma Clin Immunol. 7 Suppl 1 (Suppl 1): S3. doi:10.1186/1710-1492-7-S1-S3. PMC 3245436. PMID 22166009.
- ↑ Small P, Kim H (2011). "Allergic rhinitis". Allergy Asthma Clin Immunol. 7 Suppl 1 (Suppl 1): S3. doi:10.1186/1710-1492-7-S1-S3. PMC 3245436. PMID 22166009.
- ↑ Wheatley LM, Togias A (2015). "Clinical practice. Allergic rhinitis". N Engl J Med. 372 (5): 456–63. doi:10.1056/NEJMcp1412282. PMC 4324099. PMID 25629743.
- ↑ Small P, Kim H (2011). "Allergic rhinitis". Allergy Asthma Clin Immunol. 7 Suppl 1 (Suppl 1): S3. doi:10.1186/1710-1492-7-S1-S3. PMC 3245436. PMID 22166009.
- ↑ "StatPearls". 2022. PMID 29083833.
- ↑ Graves NS (2013). "Acute gastroenteritis". Prim Care. 40 (3): 727–41. doi:10.1016/j.pop.2013.05.006. PMC 7119329 Check
|pmc=
value (help). PMID 23958366.