Yellow fever: Difference between revisions
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*Endemic in tropical areas of sub-Sahara Africa and South America | *Endemic in tropical areas of sub-Sahara Africa and South America | ||
==Clinical Features== | ==Clinical Features== | ||
=== | ===Stage 1: Infection=== | ||
3-4 days of: | |||
** | *Fever | ||
*Remission | **[[Faget sign]] (low pulse compared to high fever) | ||
*Myalgias | |||
* | *Knee pain | ||
* | *[[Nausea]] | ||
* | *[[Vomiting]] | ||
===Stage 2: Remission=== | |||
Either recovers or progresses to next stage in 48 hours | |||
===Stage 3: Intoxication=== | |||
''15% of patients'' | |||
Return of symptoms plus: | |||
*[[Hepatic dysfunction]] | |||
*[[Renal failure]] | |||
*[[Acute coronary syndrome (main)|Myocardial injury]] | |||
*CNS dysfunction | |||
*Bleeding complications | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Influenza]] | *[[Influenza]] | ||
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{{Template:Fever in Traveler DDX}} | {{Template:Fever in Traveler DDX}} | ||
== | ==Evaluation== | ||
*CBC | *CBC | ||
*Chem | *Chem | ||
*LFTs | *LFTs | ||
*Coags | *Coags | ||
* Viral PCR | *Viral PCR | ||
*ELISA for IgM | *ELISA for IgM | ||
==Management== | ==Management== | ||
*Symptomatic | *Symptomatic | ||
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==Disposition== | ==Disposition== | ||
*Admit | *Admit | ||
== | ==References== | ||
*Lupi O. Mosquito-Borne Hemorrhagic Fevers. Dermatologic Clinics, 2011-01-01, Volume 29, Issue 1, Pages 33-38 | *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/ | *WHO Yellow fever: http://www.who.int/mediacentre/factsheets/fs100/en/ | ||
[[Category:ID]] | [[Category:ID]] |
Latest revision as of 04:40, 20 November 2017
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
Stage 1: Infection
3-4 days of:
- Fever
- Faget sign (low pulse compared to high fever)
- Myalgias
- Knee pain
- Nausea
- Vomiting
Stage 2: Remission
Either recovers or progresses to next stage in 48 hours
Stage 3: Intoxication
15% of patients 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
Evaluation
- CBC
- Chem
- LFTs
- Coags
- Viral PCR
- ELISA for IgM
Management
- Symptomatic
- Vaccination in endemic areas
Disposition
- Admit
References
- 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/