Marburg hemorrhagic fever differential diagnosis: Difference between revisions

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Latest revision as of 13:45, 23 October 2017

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

Overview

Marburg hemorrhagic fever must be differentiated from other viral hemorrhagic fevers that may cause fever, abdominal pain,and bleeding such as Ebola, Crimean-Congo hemorrhagic fever (CCHF), Hantavirus Infection, Rift Valley fever, Lujo hemorrhagic fever and Lassa fever. SInce many of the signs and symptoms of marburg hemorrhagic fever are similar to those of other infectious diseases such as malaria or typhoid fever, leptospirosis, marburg hemorrhagic fever must also be differentiated from those infections.

Differentiating Marburg Hemorrhagic Fever from other Diseases

Marburg hemorrhagic fever must be differentiated from other viral hemorrhagic fevers that may cause fever, abdominal pain,and bleeding such as Ebola, Crimean-Congo hemorrhagic fever (CCHF), Hantavirus Infection, Rift Valley fever, Lujo hemorrhagic fever and Lassa fever. SInce many of the signs and symptoms of marburg hemorrhagic fever are similar to those of other infectious diseases such as malaria or typhoid fever, leptospirosis, marburg hemorrhagic fever must also be differentiated from those infections.^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]^[9]^[10]^[11]^[12]^[13]^[14]

Virus	Disease	Incubation Period	Symptoms						Laboratory findings
			Prodromal phase					Illness phase
			Fever	Headache	Myalgia	Abdominal pain	Hemorrhage	Illness phase
Filoviruses	Marburg Hemorrhagic Fever	5-10	+	+	+	+	+	Clinically indistinguishable Maculopapular rash on the trunk (chest, back, stomach) Multiorgan failure	Thrombocytopenia Leukopenia Lymphopenia
Filoviruses	Ebola	2-21	+	+	+	+	+		Thrombocytopenia Leukopenia Lymphopenia
Bunyaviruses	Crimean-Congo hemorrhagic fever (CCHF)	13	+	+	+	+	+	Red eyes, a flushed face, a red throat, and petechiae (red spots) on the palate Changes in mood and sensory perception.
	Hantavirus Infection	9 -33	+	+	+	-	+	Flushing of the face Injection of the conjunctiva Prostration	Thrombocytopenia Leukocytosis Raised PT and aPTT Elevated hematocrit
	Rift Valley fever	2-6	+	-	+	-	-	Most commonly mild disease with recovery in 2 weeks Encephalitis Hemorrhagic fever, which occurs in less than 1% of overall RVF
Arenaviruses	Lassa fever	7-21	+	+	+	-	-	Deafness Respiratory distress Repeated vomiting Facial swelling Pain in the chest, back, and abdomen, and shock.encephalitis Hemorrhage only 20% have severe disease
	Lujo hemorrhagic fever	7-13	+	+	+	+	+	Morbilliform rash of the face and trunk Face and neck swelling Pharyngitis Diarrhea
	Lymphocytic choriomeningitis (LCM)	8-13	+	+	+	-	-	Meningitis, encephalitis, meningoencephalitis Acute hydrocephalus Myocarditis	Thrombocytopenia Leukopenia Elevated liver enzymes
Flaviviruses	Alkhurma hemorrhagic fever (AFD)	2-4	+	-	+	-	-	Neurologic symptoms Hemorrhagic symptoms only in severe form. Multi-organ failure	Thrombocytopenia Leukopenia Elevated liver enzymes
	Kyasanur Forest Disease (KFD)	3-8	+	+	+	+	+	Biphasic Complete recovery by 2 week Wave of symptoms in 3 rd week with tremors, and vision deficits.	Pancytopenia
	Omsk hemorrhagic fever	3-8	+	+	+	+	+	Biphasic Complete recovery by 2 week Wave of symptoms in 3 rd week with encephalitis	Pancytopenia

Shown below is a table summarizing the typical findings of the differential diagnoses of MHF.

Disease	Incubation period	Symptoms							Physical signs		Lab findings		Other findings
Disease	Incubation period	Fever	Cough	Rash	Joint pain	Myalgia	Diarrhea	Common hemorrhagic symptoms	Characterestic physical finding	Icterus	Plasma Creatine kinase	Confirmatory test	Other findings
Marburg hemorrhagic fever	5-10 days	+	+	Maculopapular rash on the trunk (chest, back, stomach)	+	+	+	Bloody diarrhea (Melena) Hematemesis Exanthema Petechiae/ecchymoses Mucosal hemorrhage Visceral hemorrhage	Fever and upper respiratory symptoms	-	Normal	Viral culture or PCR	History of Travel Patients with co-morbid conditions
Leptospirosis	2 to 30 days	Fever last for 4-7 days, remission for 1-2 days and then relapse	+	Present over legs hemorrhagic rash	+	+ (Severe myalgia is characteristic of leptospirosis typically localized to the calf and lumbar areas)	+	Conjunctival hemorrhage, Hemoptysis	Conjunctival suffusion	+	Elevated	Microscopic agglutination test of urine	History of exposure to soil or watercontaminated by infected rodents Recent history travel to tropical, sub tropical areas, or humid areas
Dengue	4 to 10 days	Fever last for 1-2 days, remission for 1-2 days, and then relapse for 1-2 days (Biphasic fever pattern)	-	Pruritic rash over legs and trunk (may be hemorrhagic)	+	+	-	Upper gastrointestinal bleeding	Painful lymphadenopathy	-	Normal	Serology showing positive IgM or IgG	Recent travel to South America, Africa, or Southeast Asia
Malaria	Plasmodium falciparum: 9-14 days Plasmodium vivax: 12-18 days Plasmodium ovale: 18-40 days	Fever present daily or on alternate day or every 3 days depending on Plasmodium sps.	-	No rash	-	+	-	Bloody urine	Hepatosplenomegaly	+	Normal	Giemsa stained thick and thin blood smears	Recent travel to South America, Africa, or Southeast Asia
Ebola	2 to 21 days.	+	+	Maculopapular non-pruritic rash with erythema Centripetal distribution	+	+	+ May be bloody in the early phase	Epistaxis Mucosal bleeding	Sudden onset of high fever with conjunctival injection and early gastrointestinal symptoms	-	Normal	RT-PCR	Recent visit to endemic area especially African countries
Yellow fever	3 to 6 days	+	+	-	-	+	-	Conjunctival hemorrhage, Hemoptysis	Relative bradycardia (Faget's sign)	+	Normal	RT-PCR, Nucleic acid amplification test, Immuno-histochemical staining	Recent travel to Africa, South and Central America, and the Caribbean Tropical rain forests of south America
Typhoid fever	6 to 30 days	+	-	Blanching erythematous maculopapular lesions on the lower chest and abdomen	+	+	+	Intestinal bleeding	Rose spots	-	Normal	Blood or stool culture showing salmonella typhi sps.	Residence in endemic area Recent travel to endemic area

<\small>

References

↑ Levett PN (2001). "Leptospirosis". Clin. Microbiol. Rev. 14 (2): 296–326. doi:10.1128/CMR.14.2.296-326.2001. PMC 88975. PMID 11292640.
↑ "Marburg Hemorrhagic Fever (Marburg HF) | CDC".
↑ "Chapare Hemorrhagic Fever (CHHF) | CDC".
↑ "Lassa Fever | CDC".
↑ "Lujo Hemorrhagic Fever (LUHF) | CDC".
↑ "Lymphocytic Choriomeningitis (LCM) | CDC".
↑ "Crimean-Congo Hemorrhagic Fever (CCHF) | CDC".
↑ "CDC - Hantavirus Pulmonary Syndrome (HPS) - Hantavirus".
↑ "Rift Valley Fever | CDC".
↑ "Ebola Hemorrhagic Fever | CDC".
↑ "Alkhurma Hemorrhagic Fever (AHF) | CDC".
↑ "Kyasanur Forest Disease (KFD) | CDC".
↑ "Omsk Hemorrhagic Fever | CDC".
↑ Yap S, Nguyen-Khuong T, Rudd PM, Alonso S (2017). "Dengue Virus Glycosylation: What Do We Know?". Front Microbiol. 8: 1415. doi:10.3389/fmicb.2017.01415. PMC 5524768. PMID 28791003. Vancouver style error: initials (help)

[pmid11292640-1] Levett PN (2001). "Leptospirosis". Clin. Microbiol. Rev. 14 (2): 296–326. doi:10.1128/CMR.14.2.296-326.2001. PMC 88975. PMID 11292640.

[urlMarburg_Hemorrhagic_Fever_(Marburg_HF)_|_CDC-2] "Marburg Hemorrhagic Fever (Marburg HF) | CDC".

[urlChapare_Hemorrhagic_Fever_(CHHF)_|_CDC-3] "Chapare Hemorrhagic Fever (CHHF) | CDC".

[urlLassa_Fever_|_CDC-4] "Lassa Fever | CDC".

[urlLujo_Hemorrhagic_Fever_(LUHF)_|_CDC-5] "Lujo Hemorrhagic Fever (LUHF) | CDC".

[urlLymphocytic_Choriomeningitis_(LCM)_|_CDC-6] "Lymphocytic Choriomeningitis (LCM) | CDC".

[urlCrimean-Congo_Hemorrhagic_Fever_(CCHF)_|_CDC-7] "Crimean-Congo Hemorrhagic Fever (CCHF) | CDC".

[urlCDC_-_Hantavirus_Pulmonary_Syndrome_(HPS)_-_Hantavirus-8] "CDC - Hantavirus Pulmonary Syndrome (HPS) - Hantavirus".

[urlRift_Valley_Fever_|_CDC-9] "Rift Valley Fever | CDC".

[urlEbola_Hemorrhagic_Fever_|_CDC-10] "Ebola Hemorrhagic Fever | CDC".

[urlAlkhurma_Hemorrhagic_Fever_(AHF)_|_CDC-11] "Alkhurma Hemorrhagic Fever (AHF) | CDC".

[urlKyasanur_Forest_Disease_(KFD)_|_CDC-12] "Kyasanur Forest Disease (KFD) | CDC".

[urlOmsk_Hemorrhagic_Fever_|_CDC-13] "Omsk Hemorrhagic Fever | CDC".

[pmid28791003-14] Yap S, Nguyen-Khuong T, Rudd PM, Alonso S (2017). "Dengue Virus Glycosylation: What Do We Know?". Front Microbiol. 8: 1415. doi:10.3389/fmicb.2017.01415. PMC 5524768. PMID 28791003. Vancouver style error: initials (help)

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Marburg hemorrhagic fever}}
-{{CMG}}{{AE}}
+{{CMG}} ; {{AE}} {{ADG}}
 ==Overview==
-Marburg hemorrhagic fever must be differentiated from other viral hemorrhagic fevers that may cause fever, abdominal pain,and bleeding such as Ebola, Crimean-Congo hemorrhagic fever (CCHF), Hantavirus Infection, Rift Valley fever, Lujo hemorrhagic fever and Lassa fever. Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases such as malaria or typhoid fever, leptospirosis, Marburg hemorrhagic fever must also be differentiated from those infections.
+Marburg hemorrhagic fever must be differentiated from other viral hemorrhagic fevers that may cause fever, abdominal pain,and bleeding such as [[Ebola]], [[Crimean-Congo hemorrhagic fever]] (CCHF), [[Hantavirus infection|Hantavirus Infection]], [[Rift valley fever|Rift Valley fever]], Lujo hemorrhagic fever and [[Lassa fever]]. SInce many of the signs and symptoms of marburg hemorrhagic fever are similar to those of other infectious diseases such as [[malaria]] or [[Typhoid fever|typhoid]] fever, [[leptospirosis]], marburg hemorrhagic fever must also be differentiated from those infections.
 ==Differentiating Marburg Hemorrhagic Fever from other Diseases==
-Marburg hemorrhagic fever must be differentiated from other viral hemorrhagic fevers that may cause fever, abdominal pain,and bleeding such as Ebola, Crimean-Congo hemorrhagic fever (CCHF), Hantavirus Infection, Rift Valley fever, Lujo hemorrhagic fever and Lassa fever. Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases such as malaria or typhoid fever, leptospirosis, Marburg hemorrhagic fever must also be differentiated from those infections.<ref name="pmid11292640">{{cite journal |vauthors=Levett PN |title=Leptospirosis |journal=Clin. Microbiol. Rev. |volume=14 |issue=2 |pages=296–326 |year=2001 |pmid=11292640 |pmc=88975 |doi=10.1128/CMR.14.2.296-326.2001 |url=}}</ref><ref name="urlMarburg Hemorrhagic Fever (Marburg HF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/marburg/index.html |title=Marburg Hemorrhagic Fever (Marburg HF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlChapare Hemorrhagic Fever (CHHF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/chapare/index.html |title=Chapare Hemorrhagic Fever (CHHF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlLassa Fever | CDC">{{cite web |url=https://www.cdc.gov/vhf/lassa/index.html |title=Lassa Fever &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlLujo Hemorrhagic Fever (LUHF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/lujo/index.html |title=Lujo Hemorrhagic Fever (LUHF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlLymphocytic Choriomeningitis (LCM) | CDC">{{cite web |url=https://www.cdc.gov/vhf/lcm/index.html |title=Lymphocytic Choriomeningitis (LCM) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlCrimean-Congo Hemorrhagic Fever (CCHF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/crimean-congo/index.html |title=Crimean-Congo Hemorrhagic Fever (CCHF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlCDC - Hantavirus Pulmonary Syndrome (HPS) - Hantavirus">{{cite web |url=https://www.cdc.gov/hantavirus/hps/index.html |title=CDC - Hantavirus Pulmonary Syndrome (HPS) - Hantavirus |format= |work= |accessdate=}}</ref><ref name="urlRift Valley Fever | CDC">{{cite web |url=https://www.cdc.gov/vhf/rvf/index.html |title=Rift Valley Fever &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlEbola Hemorrhagic Fever | CDC">{{cite web |url=https://www.cdc.gov/vhf/ebola/index.html |title=Ebola Hemorrhagic Fever &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlAlkhurma Hemorrhagic Fever (AHF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/alkhurma/index.html |title=Alkhurma Hemorrhagic Fever (AHF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlKyasanur Forest Disease (KFD) | CDC">{{cite web |url=https://www.cdc.gov/vhf/kyasanur/index.html |title=Kyasanur Forest Disease (KFD) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlOmsk Hemorrhagic Fever | CDC">{{cite web |url=https://www.cdc.gov/vhf/omsk/index.html |title=Omsk Hemorrhagic Fever &#124; CDC |format= |work= |accessdate=}}</ref><ref name="pmid28791003">{{cite journal |vauthors=Yap SSL, Nguyen-Khuong T, Rudd PM, Alonso S |title=Dengue Virus Glycosylation: What Do We Know? |journal=Front Microbiol |volume=8 |issue= |pages=1415 |year=2017 |pmid=28791003 |pmc=5524768 |doi=10.3389/fmicb.2017.01415 |url=}}</ref>
+Marburg hemorrhagic fever must be differentiated from other viral hemorrhagic fevers that may cause fever, abdominal pain,and bleeding such as [[Ebola]], [[Crimean-Congo hemorrhagic fever]] (CCHF), [[Hantavirus infection|Hantavirus Infection]], [[Rift valley fever|Rift Valley fever]], Lujo hemorrhagic fever and [[Lassa fever]]. SInce many of the signs and symptoms of marburg hemorrhagic fever are similar to those of other infectious diseases such as [[malaria]] or [[Typhoid fever|typhoid]] fever, [[leptospirosis]], marburg hemorrhagic fever must also be differentiated from those infections.<ref name="pmid11292640">{{cite journal |vauthors=Levett PN |title=Leptospirosis |journal=Clin. Microbiol. Rev. |volume=14 |issue=2 |pages=296–326 |year=2001 |pmid=11292640 |pmc=88975 |doi=10.1128/CMR.14.2.296-326.2001 |url=}}</ref><ref name="urlMarburg Hemorrhagic Fever (Marburg HF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/marburg/index.html |title=Marburg Hemorrhagic Fever (Marburg HF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlChapare Hemorrhagic Fever (CHHF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/chapare/index.html |title=Chapare Hemorrhagic Fever (CHHF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlLassa Fever | CDC">{{cite web |url=https://www.cdc.gov/vhf/lassa/index.html |title=Lassa Fever &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlLujo Hemorrhagic Fever (LUHF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/lujo/index.html |title=Lujo Hemorrhagic Fever (LUHF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlLymphocytic Choriomeningitis (LCM) | CDC">{{cite web |url=https://www.cdc.gov/vhf/lcm/index.html |title=Lymphocytic Choriomeningitis (LCM) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlCrimean-Congo Hemorrhagic Fever (CCHF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/crimean-congo/index.html |title=Crimean-Congo Hemorrhagic Fever (CCHF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlCDC - Hantavirus Pulmonary Syndrome (HPS) - Hantavirus">{{cite web |url=https://www.cdc.gov/hantavirus/hps/index.html |title=CDC - Hantavirus Pulmonary Syndrome (HPS) - Hantavirus |format= |work= |accessdate=}}</ref><ref name="urlRift Valley Fever | CDC">{{cite web |url=https://www.cdc.gov/vhf/rvf/index.html |title=Rift Valley Fever &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlEbola Hemorrhagic Fever | CDC">{{cite web |url=https://www.cdc.gov/vhf/ebola/index.html |title=Ebola Hemorrhagic Fever &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlAlkhurma Hemorrhagic Fever (AHF) | CDC">{{cite web |url=https://www.cdc.gov/vhf/alkhurma/index.html |title=Alkhurma Hemorrhagic Fever (AHF) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlKyasanur Forest Disease (KFD) | CDC">{{cite web |url=https://www.cdc.gov/vhf/kyasanur/index.html |title=Kyasanur Forest Disease (KFD) &#124; CDC |format= |work= |accessdate=}}</ref><ref name="urlOmsk Hemorrhagic Fever | CDC">{{cite web |url=https://www.cdc.gov/vhf/omsk/index.html |title=Omsk Hemorrhagic Fever &#124; CDC |format= |work= |accessdate=}}</ref><ref name="pmid28791003">{{cite journal |vauthors=Yap SSL, Nguyen-Khuong T, Rudd PM, Alonso S |title=Dengue Virus Glycosylation: What Do We Know? |journal=Front Microbiol |volume=8 |issue= |pages=1415 |year=2017 |pmid=28791003 |pmc=5524768 |doi=10.3389/fmicb.2017.01415 |url=}}</ref>
 {|
 ! rowspan="3" style="background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Virus}}
@@ Line 27: / Line 27: @@
 | style="background: #DCDCDC; text-align: center;" |Marburg Hemorrhagic Fever
 | style="background: #F5F5F5; text-align: center;" |5-10
-| style="background: #F5F5F5; text-align: center;" | +
+| style="background: #F5F5F5; text-align: center;" | '''+'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | rowspan="2" style="background: #F5F5F5;" |
 * '''Clinically indistinguishable'''
-* Maculopapular rash on the trunk (chest, back, stomach)
+* [[Maculopapular rash]] on the trunk (chest, back, stomach)
-* Multiorgan failure
+* [[Multiorgan failure]]
 | rowspan="2" style="background: #F5F5F5;" |
+* [[Thrombocytopenia]]
+* [[Leukopenia]]
+* [[Lymphocytopenia|Lymphopenia]]
 |-
 | style="background: #DCDCDC; text-align: center;" |Ebola
 | style="background: #F5F5F5; text-align: center;" |2-21
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''+'''
-| style="background: #F5F5F5; text-align: center;" | +
+| style="background: #F5F5F5; text-align: center;" | '''+'''
 |-
 | rowspan="3" style="background: #DCDCDC; text-align: center;" |Bunyaviruses
 | style="background: #DCDCDC; text-align: center;" |Crimean-Congo hemorrhagic fever (CCHF)
 | style="background: #F5F5F5; text-align: center;" |13
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5;" |
-* Red eyes, a flushed face, a red throat, and petechiae (red spots) on the palate
+* [[Red eyes]], a flushed face, a red throat, and petechiae (red spots) on the palate
-* changes in mood and sensory perception.
+* Changes in mood and sensory perception.
 | style="background: #F5F5F5;" |
@@ Line 62: / Line 65: @@
 | style="background: #DCDCDC; text-align: center;" |Hantavirus Infection
 | style="background: #F5F5F5; text-align: center;" | 9 -33
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5;" |
 * [[Flushing]] of the face
@@ Line 72: / Line 75: @@
 * [[Prostration]]
 | style="background: #F5F5F5;" |
+* [[Thrombocytopenia]]
+* [[Leukocytosis]]
+* Raised [[PT]] and aPTT
+* '''[[Hematocrit|Elevated hematocrit]]'''
 |-
 | style="background: #DCDCDC; text-align: center;" |Rift Valley fever
 | style="background: #F5F5F5; text-align: center;" |2-6
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5;" |
 * '''Most commonly mild disease''' with recovery in 2 weeks
-* Encephalitis, or inflammation of the brain
+* [[Encephalitis]]
 * Hemorrhagic fever, which occurs in '''less than''' 1% of overall RVF
 | style="background: #F5F5F5;" |
@@ Line 91: / Line 99: @@
 | style="background: #DCDCDC; text-align: center;" |Lassa fever
 | style="background: #F5F5F5; text-align: center;" |7-21
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5;" |
-* '''Deafness'''
+* '''[[Deafness]]'''
-* '''Respiratory distress'''
+* '''[[Respiratory distress]]'''
 * Repeated vomiting
 * Facial swelling
 * Pain in the chest, back, and abdomen, and shock.encephalitis
-* Hemorrhage only 20% have severe disease
+* [[Hemorrhage]] only 20% have severe disease
 | style="background: #F5F5F5;" |
 |-
 | style="background: #DCDCDC; text-align: center;" |Lujo hemorrhagic fever
 | style="background: #F5F5F5; text-align: center;" | 7-13
-| style="background: #F5F5F5; text-align: center;" |
+| style="background: #F5F5F5; text-align: center;" |'''+'''
-| style="background: #F5F5F5; text-align: center;" |
+| style="background: #F5F5F5; text-align: center;" |'''+'''
-| style="background: #F5F5F5; text-align: center;" |
+| style="background: #F5F5F5; text-align: center;" |'''+'''
-| style="background: #F5F5F5; text-align: center;" |
+| style="background: #F5F5F5; text-align: center;" |'''+'''
-| style="background: #F5F5F5; text-align: center;" |
+| style="background: #F5F5F5; text-align: center;" |'''+'''
 | style="background: #F5F5F5;" |
 * Morbilliform rash of the face and trunk
 * '''Face and neck swelling'''
-* '''Pharyngitis'''
+* '''[[Pharyngitis]]'''
-* Diarrhea
+* [[Diarrhea]]
 | style="background: #F5F5F5;" |
@@ Line 122: / Line 130: @@
 | style="background: #DCDCDC; text-align: center;" |Lymphocytic choriomeningitis (LCM)
 | style="background: #F5F5F5; text-align: center;" | 8-13
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5;" |
-* Meningitis, encephalitis, meningoencephalitis
+* [[Meningitis]], [[encephalitis]], [[meningoencephalitis]]
-* Acute hydrocephalus
+* Acute [[hydrocephalus]]
-* '''Myocarditis'''
+* '''[[Myocarditis]]'''
 | style="background: #F5F5F5;" |
+* [[Thrombocytopenia]]
+* [[Leukopenia]]
+* Elevated liver enzymes
 |-
@@ Line 137: / Line 148: @@
 | style="background: #DCDCDC; text-align: center;" |Alkhurma hemorrhagic fever (AFD)
 | style="background: #F5F5F5; text-align: center;" |2-4
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; text-align: center;" |<nowiki>-</nowiki>
@@ Line 145: / Line 156: @@
 * Neurologic symptoms
 * '''Hemorrhagic symptoms only''' in severe form.
-* Multi-organ failure
+* [[Multiorgan failure|Multi-organ failure]]
 | style="background: #F5F5F5;" |
-* Thrombocytopenia,
+* [[Thrombocytopenia]]
-* Leukopenia
+* [[Leukopenia]]
 * Elevated liver enzymes
 |-
 | style="background: #DCDCDC; text-align: center;" |Kyasanur Forest Disease (KFD)
 | style="background: #F5F5F5; text-align: center;" |3-8
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5;" |'''<u>Biphasic</u>'''
 * Complete recovery by 2 week
-* Wave of symptoms in 3 rd week with '''tremors, and vision deficits.'''
+* Wave of symptoms in 3 rd week with '''[[tremors]], and [[Blindness|vision deficits]].'''
 | style="background: #F5F5F5;" |
-* Pancytopenia
+* [[Pancytopenia]]
 |-
 | style="background: #DCDCDC; text-align: center;" |Omsk hemorrhagic fever
 | style="background: #F5F5F5; text-align: center;" | 3-8
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
-| style="background: #F5F5F5; text-align: center;" |<nowiki>+</nowiki>
+| style="background: #F5F5F5; text-align: center;" |'''<nowiki>+</nowiki>'''
 | style="background: #F5F5F5;" |'''<u>Biphasic</u>'''
 * Complete recovery by 2 week
-* Wave of symptoms in 3 rd week with '''encephalitis'''
+* Wave of symptoms in 3 rd week with '''[[encephalitis]]'''
 | style="background: #F5F5F5;" |
-* Pancytopenia
+* [[Pancytopenia]]
 |}
@@ Line 181: / Line 192: @@
 '''''Shown below is a table summarizing the typical findings of the differential diagnoses of MHF.'''''
-{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+<small><small>
-|+
-! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Disease}}
-! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Findings}}
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Shigellosis]] & other bacterial enteric infections'''
-| style="padding: 5px 5px; background: #F5F5F5;" | Presents with [[diarrhea]], possibly [[Dysentery|bloody]], accompanied by [[fever]], [[nausea]], and sometimes [[toxemia]], [[vomiting]], [[cramps]], and [[tenesmus]]. [[Stool]]s contain [[blood]] and mucous in a typical case. A search for possible sites of bacterial infection, together with cultures and [[blood smear]]s, should be made. Presence of [[leucocytosis]] distinguishes bacterial infections.
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Typhoid fever]]'''
-| style="padding: 5px 5px; background: #F5F5F5;" | Presents with [[fever]], [[headache]], [[rash]], gastrointestinal symptoms, with [[lymphadenopathy]], relative [[bradycardia]], [[cough]] and [[leucopenia]] and sometimes [[sore throat]]. [[Blood]] and [[stool culture]] can demonstrate causative bacteria.
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Malaria]]'''
-| style="padding: 5px 5px; background: #F5F5F5;" |Presents with acute [[fever]], [[headache]] and sometime [[diarrhea]] (children). [[Blood smear]]s must be examined for malaria parasites. Presence of [[parasites]] does not exclude concurrent viral infection. [[Antimalarial]] must be prescribed in an attempt at therapy.
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Lassa fever]]'''
-| style="padding: 5px 5px; background: #F5F5F5;" |Disease onset is usually gradual, with [[fever]], [[sore throat]], [[cough]], [[pharyngitis]], and [[facial edema]] in the later stages. Inflammation and exudation of the [[pharynx]] and [[conjunctiva]] are common.
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Yellow fever]] and other [[Flaviviridae]] '''
-| style="padding: 5px 5px; background: #F5F5F5;" | Present with [[hemorraghe|hemorrhagic]] complications. Epidemiological investigation may reveal a pattern of disease transmission by an insect vector. Virus isolation and serological investigation serves to distinguish these [[virus]]. Confirmed history of previous [[yellow fever]] [[vaccination]] will rule out [[yellow fever]].
-|-
-| style="padding: 5px 5px; background: #DCDCDC;" | '''Others'''
-| style="padding: 5px 5px; background: #F5F5F5;" |[[Viral hepatitis]], [[leptospirosis]], [[rheumatic fever]], [[typhus]], and [[mononucleosis]] produce signs and symptoms that may be confused with [[Ebola]] in the early stages of infection.
-|-
-| colspan="2" style="padding: 5px 5px; background: #FFF;" | <SMALL>Table adapted from WHO Guidelines For Epidemic Preparedness And Response: Ebola Haemorrhagic Fever <ref name="WHO">{{cite web| title=WHO Guidelines For Epidemic Preparedness And Response: Ebola Haemorrhagic Fever |url= http://apps.who.int/iris/handle/10665/63806 }} </ref></SMALL>
-|-
-|}
 {|
 ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
@@ Line 227: / Line 212: @@
 ! style="background:#7d7d7d; color: #FFFFFF;" align="center" + |Plasma Creatine kinase
 ! style="background:#7d7d7d; color: #FFFFFF;" align="center" + |Confirmatory test
+|-
+! style="background:#DCDCDC;" align="center" + |Marburg hemorrhagic fever
+| style="background:#F5F5F5;" + |
+*5-10 days
+| style="background:#F5F5F5;" align="center" + | +
+| style="background:#F5F5F5;" align="center" + | +
+| style="background:#F5F5F5;" align="center" + | [[Maculopapular rash]] on the trunk (chest, back, stomach)
+| style="background:#F5F5F5;" align="center" + | +
+| style="background:#F5F5F5;" align="center" + | +
+| style="background:#F5F5F5;" align="center" + | +
+| style="background:#F5F5F5;" align="center" + |
+* [[Bloody diarrhea]] ([[Melena]])
+* [[Hematemesis]]
+* Exanthema
+* [[Petechiae]]/[[ecchymoses]]
+* [[Mucosal]] [[hemorrhage]]
+* [[Visceral]] [[hemorrhage]]
+| style="background:#F5F5F5;" align="center" + |[[Fever]] and upper [[respiratory]] symptoms
+| style="background:#F5F5F5;" align="center" + | -
+| style="background:#F5F5F5;" align="center" + |Normal
+| style="background:#F5F5F5;" align="center" + |[[Viral culture]] or [[PCR]]
+| style="background:#F5F5F5;" + |
+*History of Travel
+*Patients with co-morbid conditions
 |-
 ! style="background:#DCDCDC;" align="center" + |[[Leptospirosis]]
@@ Line 301: / Line 310: @@
 | style="background:#F5F5F5;" + |
 *Recent visit to endemic area especially African countries
-|-
-! style="background:#DCDCDC;" align="center" + |'''[[Influenza]]'''
-| style="background:#F5F5F5;" + |
-*1-4 days
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | +/-
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | -
-| style="background:#F5F5F5;" align="center" + |[[Fever]] and upper [[respiratory]] symptoms
-| style="background:#F5F5F5;" align="center" + | -
-| style="background:#F5F5F5;" align="center" + |Normal
-| style="background:#F5F5F5;" align="center" + |[[Viral culture]] or [[PCR]]
-| style="background:#F5F5F5;" + |
-*Health care workers
-*Patients with co-morbid conditions
 |-
 ! style="background:#DCDCDC;" align="center" + |'''[[Yellow fever]]'''
@@ Line 356: / Line 347: @@
 *Recent travel to [[endemic]] area
 |}
+<\small>
 ==References==

Marburg hemorrhagic fever differential diagnosis: Difference between revisions

Latest revision as of 13:45, 23 October 2017

Overview

Differentiating Marburg Hemorrhagic Fever from other Diseases

References

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