Viral syndrome: Difference between revisions

Latest revision as of 15:25, 14 September 2019

Background

Among the most common illnesses encountered in ED
Majority trivial, some may be life-threatening
Depending on the type of virus: may be transmitted via direct contact, droplet, fecal-oral, saliva, sexual contact, venereal, or vertical transmission.

Clinical Features

Generalized viral features
- Myalgia
- Arthralgia
- Fever
- Lymphadenopathy
- Rash
Specific viral syndromes
- Gastroenteritis
- Encephalitis
- Hepatitis
- Meningitis
- Viral pneumonia
- URI

Differential Diagnosis

Viral infections

Adenovirus
Acute Bronchitis
Arbovirus
CMV
Coronavirus
Coxsackie virus
- Hand-foot-and-mouth disease
Herpesvirus
- Herpangina
HIV (Acute Retroviral Syndrome)
Infectious mononucleosis (EBV)
Influenza virus
Laryngitis
Rhinovirus
Varicella

Fever

Infectious

Critical
- Sepsis
- PNA with respiratory failure
- Peritonitis
- Meningitis
- Cavernous Sinus Thrombosis
- Necrotizing Fasciitis
Emergent
- PNA
- Peritonsillar Abscess
- Retropharyngeal Abscess
- Epiglottitis
- Endocarditis
- Pericarditis
- Appendicitis
- Cholecystitis
- Diverticulitis
- Intra-abdominal abscess
- Pyelonephritis
- Tubo-ovarian abscess
- Encephalitis
- Brain abscess
- Cellulitis
- Abscess
- Malaria
Non-emergent
- Viral syndrome
- Otitis Media
- Sinusitis
- Pharyngitis
- Influenza
- TB
- UTI
- Epididymitis
- Prostatitis

Non-infectious

Critical
Emergent
- CHF
- Dehydration
- Recent Seizure
- Sickle Cell Dz
- Transplant rejection
- Pancreatitis
- DVT
- Serotonin Syndrome
Non-emergent
- Drug fever (except as in NMS and Serotonin Syndrome)
- Malignancy
- Gout
- Sarcoidosis
- Crohn's Disease
- Postmyocardiotomy syndrome
- Sweet's syndrome

Evaluation

Clinical diagnosis
Serology testing may be indicated to diagnose or rule-out life-threatening causes

Management

Symptomatic management
Exclude other causes if serious presentation
- Consider empiric acyclovir and antibiotics until HSV and bacterial causes ruled out.

Disposition

Outpatient treatment

External Links

References

Takhar SS, Moran GJ. Disseminated Viral Infections. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. New York, NY: McGraw-Hill; 2011.

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
+*Among the most common illnesses encountered in ED
+*Majority trivial, some may be life-threatening
+*Depending on the type of virus: may be transmitted via direct contact, droplet, fecal-oral, saliva, sexual contact, venereal, or vertical transmission.
 ==Clinical Features==
+*Generalized viral features
+**[[Myalgia]]
+**[[Arthralgia]]
+**[[Fever]]
+**[[Lymphadenopathy]]
+**[[Rash]]
+*Specific viral syndromes
+**[[Gastroenteritis]]
+**[[Encephalitis]]
+**[[Hepatitis]]
+**[[Meningitis]]
+**Viral [[pneumonia]]
+**[[URI]]
 ==Differential Diagnosis==
+====Viral infections====
+*[[Adenovirus]]
+*[[Acute Bronchitis]]
+*[[Arbovirus]]
+*[[CMV]]
+*[[Coronavirus]]
+*[[Coxsackie virus]]
+**[[Hand-foot-and-mouth disease]]
+*[[Herpes simplex virus|Herpesvirus]]
+**[[Herpangina]]
+*[[HIV - AIDS (Main)|HIV]] (Acute Retroviral Syndrome)
+*[[Infectious mononucleosis]] (EBV)
+*[[Influenza]] virus
+*[[Laryngitis]]
+*[[Rhinovirus]]
+*[[Varicella]]
-==Diagnosis==
+{{Acute Fever DDX}}
+==Evaluation==
+*Clinical diagnosis
+*Serology testing may be indicated to diagnose or rule-out life-threatening causes
 ==Management==
+*Symptomatic management
+*Exclude other causes if serious presentation
+**Consider empiric acyclovir and antibiotics until [[HSV]] and bacterial causes ruled out.
 ==Disposition==
+*Outpatient treatment
 ==See Also==
+*[[Fever]]
 ==External Links==
 ==References==
+*Takhar SS, Moran GJ. Disseminated Viral Infections. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. New York, NY: McGraw-Hill; 2011.
 <references/>
+[[Category:ID]]