Yellow fever: Difference between revisions

(Text replacement - "==Diagnosis==" to "==Evaluation==")
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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==
===3 stages===
===Stage 1: Infection===
*Infection- 3 to 4 days of fever, myalgias, knee pain, nausea, vomiting
3-4 days of:
*Fever
**Faget’s sign-low pulse compare to high fever
**Faget’s sign-low pulse compare to high fever
*Remission- either recovers or progresses to next stage in 48 hours
*[[Myalgias]]
*Intoxication- 15% of patients with return of symptoms plus:
*[[Knee pain]]
**Hepatic dysfunction
*[[Nausea]]
**Renal failure
*[[Vomiting]]
**Myocardial injury
 
**CNS dysfunction
===Stage 2: Remission===
**Bleeding complications
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

Evaluation

  • CBC
  • Chem
  • LFTs
  • Coags
  • Viral PCR
  • ELISA for IgM

Management

  • Symptomatic
  • Vaccination in endemic areas

Disposition

  • Admit

References