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 | |||
**Faget’s sign-low pulse compare to high fever | **Faget’s sign-low pulse compare to high fever | ||
*Remission | *[[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== | ==Differential Diagnosis== | ||
*[[Influenza]] | *[[Influenza]] | ||
Revision as of 02:38, 14 December 2016
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:
Stage 2: Remission
Either recovers or progresses to next stage in 48 hours
Stage 3: Intoxication
15% of patients Return of symptoms plus:
[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/
