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==
===3 stages===
===Stage 1: Infection===
*Infection- 3 to 4 days of fever, myalgias, knee pain, nausea, vomiting
3-4 days of:
**Faget’s sign-low pulse compare to high fever
*Fever
*Remission- either recovers or progresses to next stage in 48 hours
**[[Faget sign]] (low pulse compared to high fever)
*Intoxication- 15% of patients with return of symptoms plus:
*Myalgias
**Hepatic dysfunction
*Knee pain
**Renal failure
*[[Nausea]]
**Myocardial injury
*[[Vomiting]]
**CNS dysfunction
 
**Bleeding complications
===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]]
*[[Dengue]]
*[[Acute Hepatitis]]
*[[Leptospirosis]]
 
*[[Acute hepatitis]]
{{Template:Fever in Traveler DDX}}
*[[Rift Valley fever]]
 
*[[Q fever]]
==Evaluation==
*[[Typhoid fever]]
*[[Malaria]]
==Workup==
*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
==Sources==
==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/
*Uptodate
 
[[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:

Stage 2: Remission

Either recovers or progresses to next stage in 48 hours

Stage 3: Intoxication

15% of patients Return of symptoms plus:

Differential Diagnosis

Fever in traveler

Evaluation

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

Management

  • Symptomatic
  • Vaccination in endemic areas

Disposition

  • Admit

References