Yellow fever: Difference between revisions
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*[[Hepatic dysfunction]] | *[[Hepatic dysfunction]] | ||
*[[Renal failure]] | *[[Renal failure]] | ||
[Myocardial injury | *[[Acute coronary syndrome (main)|Myocardial injury]] | ||
*CNS dysfunction | *CNS dysfunction | ||
*Bleeding complications | *Bleeding complications | ||
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/