Embed Size (px)
DESCRIPTION
from http://emedicine.medscape.com
Citation preview
10/12/2015 Dengue Differential Diagnoses
http://emedicine.medscape.com/article/215840differential 1/5
Dengue Differential DiagnosesAuthor: Suzanne Moore Shepherd, MD, MS, DTM&H, FACEP, FAAEM; Chief Editor: Michael StuartBronze, MD more...
Updated: Oct 05, 2015
Diagnostic ConsiderationsStudies indicate that as many as 50% of dengue cases may be misdiagnosed, as aresult of inaccurate assessment of the signs and symptoms of disease presentation.This inaccuracy can lead to increased cost of treatment, such as unneededhospitalizations, as well as possibly increased morbidity and mortality due to volumeoverload from overzealous use of intravenous fluids.[47]
A Belgian study examined predictors of diagnosis in 1962 febrile travelers andexpatriates returning from the tropics. After malaria was ruled out, the mainpredictors of dengue infection included skin rash, thrombocytopenia, andleukopenia.[48]
Dengue must be carefully differentiated from preeclampsia during pregnancy. Anoverlap of symptoms and signs, including thrombocytopenia, impaired liver function,capillary leak, ascites, and decreased urine output may make this clinicallychallenging. Definitive diagnosis is confirmed via serology.
Rare cases of vertical dengue transmission have been reported. If the motheracquires infection in the peripartum period, newborns should be evaluated fordengue with platelet counts and serologic studies.[49, 50]
Other problems to be considered in the differential diagnosis of dengue include thefollowing:
Chikungunya virusMayaro feverRoss River feverSindbis virusEbola virusHemorrhagic fever virusesRiver VirusChikungunyaOrbivirusWest Nile encephalitisRoseola infantumScarlet feverIdiopathic thrombocytopenic purpura
Differential DiagnosesArenaviruses
Influenza
Leptospirosis
Malaria
Meningitis
Rickettsial Infection
Rocky Mountain Spotted Fever
Typhus
Viral Hepatitis
Yellow Fever
Workup
Contributor Information and DisclosuresAuthorSuzanne Moore Shepherd, MD, MS, DTM&H, FACEP, FAAEM Professor of Emergency Medicine, EducationOfficer, Department of Emergency Medicine, Hospital of the University of Pennsylvania; Director of Educationand Research, PENN Travel Medicine; Medical Director, Fast Track, Department of Emergency Medicine
Suzanne Moore Shepherd, MD, MS, DTM&H, FACEP, FAAEM is a member of the following medical societies:Alpha Omega Alpha, American Academy of Emergency Medicine, American Society of Tropical Medicine andHygiene, International Society of Travel Medicine, Society for Academic Emergency Medicine, WildernessMedical Society
Disclosure: Nothing to disclose.
Coauthor(s)Patrick B Hinfey, MD Emergency Medicine Residency Director, Department of Emergency Medicine, NewarkBeth Israel Medical Center; Clinical Assistant Professor of Emergency Medicine, New York College ofOsteopathic Medicine
Patrick B Hinfey, MD is a member of the following medical societies: American Academy of Emergency
10/12/2015 Dengue Differential Diagnoses
http://emedicine.medscape.com/article/215840differential 2/5
Medicine, Wilderness Medical Society, American College of Emergency Physicians, Society for AcademicEmergency Medicine
Disclosure: Nothing to disclose.
William H Shoff, MD, DTM&H Director, PENN Travel Medicine; Associate Professor, Department of EmergencyMedicine, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine
William H Shoff, MD, DTM&H is a member of the following medical societies: American College of Physicians,American Society of Tropical Medicine and Hygiene, International Society of Travel Medicine, Society forAcademic Emergency Medicine, Wilderness Medical Society
Disclosure: Nothing to disclose.
Chief EditorMichael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart GWolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health ScienceCenter; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America
Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, AmericanMedical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation,Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America
Disclosure: Nothing to disclose.
AcknowledgementsJoseph Domachowske, MD Professor of Pediatrics, Microbiology and Immunology, Department of Pediatrics,Division of Infectious Diseases, State University of New York Upstate Medical University
Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, AmericanAcademy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, PediatricInfectious Diseases Society, and Phi Beta Kappa
Disclosure: Nothing to disclose.
Hagop A Isnar, MD, FACEP Department of Emergency Medicine, Crouse Hospital
Hagop A Isnar, MD, FACEP is a member of the following medical societies: American College of EmergencyPhysicians, American Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Thomas M Kerkering, MD Chief of Infectious Diseases, Virginia Tech, Carilion School of Medicine, Roanoke,Virginia
Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, AmericanCollege of Physicians, American Public Health Association, American Society for Microbiology, American Societyof Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, andWilderness Medical Society
Disclosure: Nothing to disclose.
Deborah Sentochnik, MD Consulting Staff, Department of Internal Medicine, Division of Infectious Disease,The Mary Imogene Bassett Hospital
Deborah Sentochnik, MD is a member of the following medical societies: American College of Physicians,Infectious Diseases Society of America, and Medical Society of the State of New York
Disclosure: Nothing to disclose.
Russell W Steele, MD Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center;Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics,American Association of Immunologists, American Pediatric Society, American Society for Microbiology,Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society,Society for Pediatric Research, and Southern Medical Association
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD, Adjunct Assistant Professor, University of Nebraska Medical CenterCollege of Pharmacy; EditorinChief, Medscape Drug Reference
Disclosure: Medscape Reference Salary Employment
Mary L Windle, PharmD, Adjunct Associate Professor, University of Nebraska Medical Center College ofPharmacy; EditorinChief, Medscape Drug Reference
Disclosure: Nothing to disclose.
References
1. Osterwell N. Dengue 'Underrecognized' as Source of Febrile Illness in US. Medscape Medical News. Jan23 2014. Available at http://www.medscape.com/viewarticle/819656. Accessed: January 25, 2014.
2. Sharp TM, Gaul L, Muehlenbachs A, Hunsperger E, Bhatnagar J, Lueptow R, et al. Fatal hemophagocyticlymphohistiocytosis associated with locally acquired dengue virus infection new Mexico and Texas, 2012.MMWR Morb Mortal Wkly Rep. 2014 Jan 24. 63(3):4954. [Medline].
3. Kyle JL, Harris E. Global spread and persistence of dengue. Annu Rev Microbiol. 2008. 62:7192.[Medline].
4. Statler J, Mammen M, Lyons A, Sun W. Sonographic findings of healthy volunteers infected with denguevirus. J Clin Ultrasound. 2008 Sep. 36(7):4137. [Medline].
5. Gubler DJ. Cities spawn epidemic dengue viruses. Nat Med. 2004 Feb. 10(2):12930. [Medline].
6. WilderSmith A, Gubler DJ. Geographic expansion of dengue: the impact of international travel. Med Clin
10/12/2015 Dengue Differential Diagnoses
http://emedicine.medscape.com/article/215840differential 3/5
North Am. 2008 Nov. 92(6):137790, x. [Medline].
7. Halstead SB. Dengue. Lancet. 2007 Nov 10. 370(9599):164452. [Medline].
8. Chowell G, Torre CA, MunaycoEscate C, SuárezOgnio L, LópezCruz R, Hyman JM. Spatial andtemporal dynamics of dengue fever in Peru: 19942006. Epidemiol Infect. 2008 Dec. 136(12):166777.[Medline].
9. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F. Spectrum of disease andrelation to place of exposure among ill returned travelers. N Engl J Med. 2006 Jan 12. 354(2):11930.[Medline].
10. CDC. Imported dengueUnited States, 1997 and 1998. MMWR Morb Mortal Wkly Rep. 2000 Mar 31.49(12):24853. [Medline]. [Full Text].
11. Engelthaler DM, Fink TM, Levy CE, Leslie MJ. The reemergence of Aedes aegypti in Arizona. EmergInfect Dis. 1997 AprJun. 3(2):2412. [Medline]. [Full Text].
12. Chye JK, Lim CT, Ng KB, et al. Vertical transmission of dengue. Clin Infect Dis. 1997 Dec. 25(6):13747.[Medline].
13. Wagner D, de With K, Huzly D, Hufert F, Weidmann M, Breisinger S, et al. Nosocomial acquisition ofdengue. Emerg Infect Dis. 2004 Oct. 10(10):18723. [Medline].
14. Dejnirattisai W, Duangchinda T, Lin CL, Vasanawathana S, Jones M, Jacobs M, et al. A complex interplayamong virus, dendritic cells, T cells, and cytokines in dengue virus infections. J Immunol. 2008 Nov 1.181(9):586574. [Medline].
15. Halstead SB, Heinz FX, Barrett AD, Roehrig JT. Dengue virus: molecular basis of cell entry andpathogenesis, 2527 June 2003, Vienna, Austria. Vaccine. 2005 Jan 4. 23(7):84956. [Medline].
16. Limjindaporn T, Wongwiwat W, Noisakran S, Srisawat C, Netsawang J, Puttikhunt C, et al. Interaction ofdengue virus envelope protein with endoplasmic reticulumresident chaperones facilitates dengue virusproduction. Biochem Biophys Res Commun. 2009 Feb 6. 379(2):196200. [Medline].
17. Zhang JL, Wang JL, Gao N, Chen ZT, Tian YP, An J. Upregulated expression of beta3 integrin induced bydengue virus serotype 2 infection associated with virus entry into human dermal microvascular endothelialcells. Biochem Biophys Res Commun. 2007 May 11. 356(3):7638. [Medline].
18. Rothman AL, Ennis FA. Immunopathogenesis of Dengue hemorrhagic fever. Virology. 1999 Apr 25.257(1):16. [Medline].
19. Chen LC, Lei HY, Liu CC, Shiesh SC, Chen SH, Liu HS. Correlation of serum levels of macrophagemigration inhibitory factor with disease severity and clinical outcome in dengue patients. Am J Trop MedHyg. 2006 Jan. 74(1):1427. [Medline].
20. Green S, Rothman A. Immunopathological mechanisms in dengue and dengue hemorrhagic fever. CurrOpin Infect Dis. 2006 Oct. 19(5):42936. [Medline].
21. Guzman MG, Alvarez M, RodriguezRoche R, Bernardo L, Montes T, Vazquez S. Neutralizing antibodiesafter infection with dengue 1 virus. Emerg Infect Dis. 2007 Feb. 13(2):2826. [Medline].
22. Restrepo BN, Ramirez RE, Arboleda M, Alvarez G, Ospina M, Diaz FJ. Serum levels of cytokines in twoethnic groups with dengue virus infection. Am J Trop Med Hyg. 2008 Nov. 79(5):6737. [Medline].
23. Rothman AL. Dengue: defining protective versus pathologic immunity. J Clin Invest. 2004 Apr. 113(7):94651. [Medline].
24. de Macedo FC, Nicol AF, Cooper LD, Yearsley M, Pires AR, Nuovo GJ. Histologic, viral, and molecularcorrelates of dengue fever infection of the liver using highly sensitive immunohistochemistry. Diagn MolPathol. 2006 Dec. 15(4):2238. [Medline].
25. Shah I. Dengue and liver disease. Scand J Infect Dis. 2008. 40(1112):9934. [Medline].
26. Dejnirattisai W, Jumnainsong A, Onsirisakul N, et al. Crossreacting antibodies enhance dengue virusinfection in humans. Science. 2010 May 7. 328(5979):7458. [Medline].
27. Schmidt AC. Response to dengue feverthe good, the bad, and the ugly?. N Engl J Med. 2010 Jul 29.363(5):4847. [Medline].
28. Kurane I, Innis BL, Nimmannitya S, Nisalak A, Meager A, Ennis FA. High levels of interferon alpha in thesera of children with dengue virus infection. Am J Trop Med Hyg. 1993 Feb. 48(2):2229. [Medline].
29. Wang E, Ni H, Xu R, Barrett AD, Watowich SJ, Gubler DJ. Evolutionary relationships of endemic/epidemicand sylvatic dengue viruses. J Virol. 2000 Apr. 74(7):322734. [Medline].
30. Centers for Disease Control and Prevention Web site. CDC traveler's health page. Dengue. Available athttp://www.cdc.gov/Dengue/travelOutbreaks/. Accessed: October 20, 2011.
31. Chen WS, Wong CH, Cillekens L. Dengue antibodies in a suburban community in Malaysia. Med JMalaysia. 2003 Mar. 58(1):1423. [Medline].
32. Istúriz RE, Gubler DJ, Brea del Castillo J. Dengue and dengue hemorrhagic fever in Latin America and theCaribbean. Infect Dis Clin North Am. 2000 Mar. 14(1):12140, ix. [Medline].
33. Hotez PJ, Bottazzi ME, FrancoParedes C, Ault SK, Periago MR. The neglected tropical diseases of LatinAmerica and the Caribbean: a review of disease burden and distribution and a roadmap for control andelimination. PLoS Negl Trop Dis. 2008 Sep 24. 2(9):e300. [Medline]. [Full Text].
34. Centers for Disease Control and Prevention (CDC). Travelassociated Dengue surveillance United States,20062008. MMWR Morb Mortal Wkly Rep. 2010 Jun 18. 59(23):7159. [Medline]. [Full Text].
35. Centers for Disease Control and Prevention (CDC). Locally acquired DengueKey West, Florida, 20092010. MMWR Morb Mortal Wkly Rep. 2010 May 21. 59(19):57781. [Medline].
36. Malavige GN, Fernando S, Fernando DJ, Seneviratne SL. Dengue viral infections. Postgrad Med J. 2004Oct. 80(948):588601. [Medline]. [Full Text].
37. Stephenson JR. Understanding dengue pathogenesis: implications for vaccine design. Bull World HealthOrgan. 2005 Apr. 83(4):30814. [Medline]. [Full Text].
10/12/2015 Dengue Differential Diagnoses
http://emedicine.medscape.com/article/215840differential 4/5
38. World Health Organization. Impact of Dengue. Available athttp://www.who.int/csr/disease/dengue/impact/en/index.html. Accessed: October 14, 2011.
39. Lin CC, Huang YH, Shu PY, et al. Characteristic of dengue disease in Taiwan: 20022007. Am J Trop MedHyg. 2010 Apr. 82(4):7319. [Medline]. [Full Text].
40. Anderson KB, Chunsuttiwat S, Nisalak A, Mammen MP, Libraty DH, Rothman AL. Burden of symptomaticdengue infection in children at primary school in Thailand: a prospective study. Lancet. 2007 Apr 28.369(9571):14529. [Medline].
41. Lahiri M, Fisher D, Tambyah PA. Dengue mortality: reassessing the risks in transition countries. Trans RSoc Trop Med Hyg. 2008 Oct. 102(10):10116. [Medline].
42. Beatty ME, Beutels P, Meltzer MI, et al. Health economics of dengue: a systematic literature review andexpert panel's assessment. Am J Trop Med Hyg. 2011 Mar. 84(3):47388. [Medline]. [Full Text].
43. Shepard DS, Coudeville L, Halasa YA, Zambrano B, Dayan GH. Economic impact of dengue illness in theAmericas. Am J Trop Med Hyg. 2011 Feb. 84(2):2007. [Medline]. [Full Text].
44. Suaya JA, Shepard DS, Siqueira JB, et al. Cost of dengue cases in eight countries in the Americas andAsia: a prospective study. Am J Trop Med Hyg. 2009 May. 80(5):84655. [Medline].
45. WHO. Dengue haemorrhagic fever: diagnosis, treatment, prevention and control. World HealthOrganization. 1997. Available at http://www.who.int/topics/dengue/en/.
46. Sanjay S, Wagle AM, Au Eong KG. Dengue optic neuropathy. Ophthalmology. 2009 Jan. 116(1):170;author reply 170. [Medline].
47. Teves Maria A. Wrong treatment most common cause of dengue fatality. ABS/CBN News. Available athttp://www.abscbnnews.com/nation/09/03/09/wrongtreatmentmostcommoncausedenguefatality.Accessed: September 3, 2010.
48. Bottieau E, Clerinx J, Van den Enden E, Van Esbroeck M, Colebunders R, Van Gompel A. Fever after astay in the tropics: diagnostic predictors of the leading tropical conditions. Medicine (Baltimore). 2007 Jan.86(1):1825. [Medline].
49. Malhotra N, Chanana C, Kumar S. Dengue infection in pregnancy. Int J Gynaecol Obstet. 2006 Aug.94(2):1312. [Medline].
50. Singh N, Sharma KA, Dadhwal V, Mittal S, Selvi AS. A successful management of dengue fever inpregnancy: report of two cases. Indian J Med Microbiol. 2008 OctDec. 26(4):37780. [Medline].
51. Warrilow D, Northill JA, Pyke A, Smith GA. Single rapid TaqMan fluorogenic probe based PCR assay thatdetects all four dengue serotypes. J Med Virol. 2002 Apr. 66(4):5248. [Medline].
52. Kong YY, Thay CH, Tin TC, Devi S. Rapid detection, serotyping and quantitation of dengue viruses byTaqMan realtime onestep RTPCR. J Virol Methods. 2006 Dec. 138(12):12330. [Medline].
53. Trung DT, Thao le TT, Hien TT, et al. Liver involvement associated with dengue infection in adults inVietnam. Am J Trop Med Hyg. 2010 Oct. 83(4):77480. [Medline]. [Full Text].
54. Potts JA, Rothman AL. Clinical and laboratory features that distinguish dengue from other febrile illnessesin endemic populations. Trop Med Int Health. 2008 Nov. 13(11):132840. [Medline]. [Full Text].
55. Lima EQ, Nogueira ML. Viral hemorrhagic feverinduced acute kidney injury. Semin Nephrol. 2008 Jul.28(4):40915. [Medline].
56. Lombardi R, Yu L, YounesIbrahim M, Schor N, Burdmann EA. Epidemiology of acute kidney injury inLatin America. Semin Nephrol. 2008 Jul. 28(4):3209. [Medline].
57. Chaterji S, Allen JC Jr, Chow A, Leo YS, Ooi EE. Evaluation of the NS1 rapid test and the WHO dengueclassification schemes for use as bedside diagnosis of acute dengue fever in adults. Am J Trop Med Hyg.2011 Feb. 84(2):2248. [Medline]. [Full Text].
58. Wichmann O, Stark K, Shu PY, Niedrig M, Frank C, Huang JH. Clinical features and pitfalls in thelaboratory diagnosis of dengue in travellers. BMC Infect Dis. 2006. 6:120. [Medline].
59. Domingo C, de Ory F, Sanz JC, Reyes N, Gascón J, Wichmann O, et al. Molecular and serologic markersof acute dengue infection in naive and flavivirusvaccinated travelers. Diagn Microbiol Infect Dis. 2009 Sep.65(1):428. [Medline].
60. Srikiatkhachorn A, Krautrachue A, Ratanaprakarn W, Wongtapradit L, Nithipanya N, Kalayanarooj S.Natural history of plasma leakage in dengue hemorrhagic fever: a serial ultrasonographic study. PediatrInfect Dis J. 2007 Apr. 26(4):28390; discussion 2912. [Medline].
61. Srikiatkhachorn A, Gibbons RV, Green S, et al. Dengue hemorrhagic fever: the sensitivity and specificity ofthe world health organization definition for identification of severe cases of dengue in Thailand, 19942005.Clin Infect Dis. 2010 Apr 15. 50(8):113543. [Medline]. [Full Text].
62. Setiati TE, Mairuhu AT, Koraka P, Supriatna M, Mac Gillavry MR, Brandjes DP, et al. Dengue diseaseseverity in Indonesian children: an evaluation of the World Health Organization classification system. BMCInfect Dis. 2007 Mar 26. 7:22. [Medline]. [Full Text].
63. Tassniyom S, Vasanawathana S, Chirawatkul A, Rojanasuphot S. Failure of highdose methylprednisolonein established dengue shock syndrome: a placebocontrolled, doubleblind study. Pediatrics. 1993 Jul.92(1):1115. [Medline].
64. WHO. Dengue. Available at http://www.who.int/topics/dengue/en/. Accessed: October 20, 2011.
65. Wills BA, Nguyen MD, Ha TL, Dong TH, Tran TN, Le TT, et al. Comparison of three fluid solutions forresuscitation in dengue shock syndrome. N Engl J Med. 2005 Sep 1. 353(9):87789. [Medline].
66. Yadav SP, Sachdeva A, Gupta D, Sharma SD, Kharya G. Control of massive bleeding in denguehemorrhagic fever with severe thrombocytopenia by use of intravenous antiD globulin. Pediatr BloodCancer. 2008 Dec. 51(6):8123. [Medline].
67. Waduge R, Malavige GN, Pradeepan M, Wijeyaratne CN, Fernando S, Seneviratne SL. Dengue infectionsduring pregnancy: a case series from Sri Lanka and review of the literature. J Clin Virol. 2006 Sep.37(1):2733. [Medline].
68. Ismail NA, Kampan N, Mahdy ZA, Jamil MA, Razi ZR. Dengue in pregnancy. Southeast Asian J Trop Med
10/12/2015 Dengue Differential Diagnoses
http://emedicine.medscape.com/article/215840differential 5/5
Medscape Reference © 2011 WebMD, LLC
Public Health. 2006 Jul. 37(4):6813. [Medline].
69. Billingsley PF, Foy B, Rasgon JL. Mosquitocidal vaccines: a neglected addition to malaria and denguecontrol strategies. Trends Parasitol. 2008 Sep. 24(9):396400. [Medline].
70. Erlanger TE, Keiser J, Utzinger J. Effect of dengue vector control interventions on entomologicalparameters in developing countries: a systematic review and metaanalysis. Med Vet Entomol. 2008 Sep.22(3):20321. [Medline].
71. Kay B, Vu SN. New strategy against Aedes aegypti in Vietnam. Lancet. 2005 Feb 1218. 365(9459):6137.[Medline].
72. Hanh TT, Hill PS, Kay BH, Quy TM. Development of a framework for evaluating the sustainability ofcommunitybased dengue control projects. Am J Trop Med Hyg. 2009 Feb. 80(2):3128. [Medline].
73. Monath TP. Dengue and yellow feverchallenges for the development and use of vaccines. N Engl J Med.2007 Nov 29. 357(22):22225. [Medline].
74. McArthur JH, Durbin AP, Marron JA, Wanionek KA, Thumar B, Pierro DJ, et al. Phase I clinical evaluationof rDEN4Delta30200,201: a live attenuated dengue 4 vaccine candidate designed for decreasedhepatotoxicity. Am J Trop Med Hyg. 2008 Nov. 79(5):67884. [Medline]. [Full Text].
75. O'Brien J. 12th Annual Conference on Vaccine Research. Expert Rev Vaccines. 2009 Sep. 8(9):113942.[Medline].
76. Edelman R. Dengue vaccines approach the finish line. Clin Infect Dis. 2007 Jul 15. 45 Suppl 1:S5660.[Medline].
77. Blaney JE Jr, Durbin AP, Murphy BR, Whitehead SS. Development of a live attenuated dengue virusvaccine using reverse genetics. Viral Immunol. 2006 Spring. 19(1):1032. [Medline].
78. Sanofi Pasteur and International Vaccine Institute Partner Against Dengue. Available athttp://www.dengue.info/front/index.jsp?siteCode=DENGUE. Accessed: October 20, 2011.
79. Lang J. Recent progress on sanofi pasteur's dengue vaccine candidate. J Clin Virol. 2009 Oct. 46 Suppl2:S204. [Medline].
80. Larsen CP, Whitehead SS, Durbin AP. Dengue human infection models to advance dengue vaccinedevelopment. Vaccine. 2015 Sep 28. [Medline].
