Yellow fever: Difference between revisions
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**Bleeding complications | **Bleeding complications | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Workup== | ==Workup== | ||
Revision as of 13:42, 30 September 2014
Background
- A Flavi virus transmitted by Aedes and Haemagogus mosquitos
- 200,000 cases per year with 30,000 deaths mostly in Africa
- Endemic in tropical areas of sub-Sahara Africa and South America
Clinical Features
3 stages
- Infection- 3 to 4 days of fever, myalgias, knee pain, nausea, vomiting
- Faget’s sign-low pulse compare to high fever
- Remission- either recovers or progresses to next stage in 48 hours
- Intoxication- 15% of patients with return of symptoms plus:
- Hepatic dysfunction
- Renal failure
- Myocardial injury
- CNS dysfunction
- Bleeding complications
Differential Diagnosis
Fever in traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid fever
- Typhus
- Viral hemorrhagic fevers
- Chikungunya
- Yellow fever
- Rift valley fever
- Q fever
- Amebiasis
- Zika virus
Workup
- CBC
- Chem
- LFTs
- Coags
- Viral PCR
- ELISA for IgM
Management
- Symptomatic
- Vaccination in endemic areas
Disposition
- Admit
Sources
- Lupi O. Mosquito-Borne Hemorrhagic Fevers. Dermatologic Clinics, 2011-01-01, Volume 29, Issue 1, Pages 33-38
- WHO Yellow fever: http://www.who.int/mediacentre/factsheets/fs100/en/
- Uptodate