Rabies differential diagnosis: Difference between revisions
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***[[poliovirus]]es | ***[[poliovirus]]es | ||
***human [[enterovirus]]es 68 to 71. | ***human [[enterovirus]]es 68 to 71. | ||
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*A specific diagnosis may be made by a variety of diagnostic techniques, including: | *A specific diagnosis may be made by a variety of diagnostic techniques, including: | ||
**[[polymerase chain reaction]] (PCR) testing of: | **[[polymerase chain reaction]] (PCR) testing of: | ||
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***The [[California encephalitis virus]] serogroup | ***The [[California encephalitis virus]] serogroup | ||
***[[La Crosse virus]]. | ***[[La Crosse virus]]. | ||
New causes of viral encephalitis are also possible, as was evidenced by the recent outbreak in Malaysia of some 300 cases of encephalitis (mortality rate, 40%) caused by [[Nipah virus]], a newly recognized [[paramyxovirus]]. Similarly, well-known viruses may be introduced into new locations, as is illustrated by the recent outbreak of encephalitis due to [[West Nile virus]] in the eastern United States. Epidemiologic factors (e.g., season, geographic location, and the patient’s age, travel history, and possible exposure to animal bites, rodents, and ticks) may help direct the diagnostic workup. | New causes of viral encephalitis are also possible, as was evidenced by the recent outbreak in Malaysia of some 300 cases of encephalitis (mortality rate, 40%) caused by [[Nipah virus]], a newly recognized [[paramyxovirus]]. Similarly, well-known viruses may be introduced into new locations, as is illustrated by the recent outbreak of encephalitis due to [[West Nile virus]] in the eastern United States. Epidemiologic factors (e.g., season, geographic location, and the patient’s age, travel history, and possible exposure to animal bites, rodents, and ticks) may help direct the diagnostic workup. | ||
Revision as of 13:46, 17 April 2012
The differential diagnosis in a case of suspected human rabies may initially include any cause of
- encephalitis
- particularly infection with viruses such as:
- The most important viruses to rule out are:
- herpes simplex virus type 1
- varicella-zoster virus
- (less commonly) enteroviruses including:
- coxsackieviruses
- echoviruses
- polioviruses
- human enteroviruses 68 to 71.
- A specific diagnosis may be made by a variety of diagnostic techniques, including:
- polymerase chain reaction (PCR) testing of:
- cerebrospinal fluid
- viral culture
- serology.
- In addition, consideration should be given to the local epidemiology of encephalitis caused by arboviruses belonging to several taxonomic groups, including:
New causes of viral encephalitis are also possible, as was evidenced by the recent outbreak in Malaysia of some 300 cases of encephalitis (mortality rate, 40%) caused by Nipah virus, a newly recognized paramyxovirus. Similarly, well-known viruses may be introduced into new locations, as is illustrated by the recent outbreak of encephalitis due to West Nile virus in the eastern United States. Epidemiologic factors (e.g., season, geographic location, and the patient’s age, travel history, and possible exposure to animal bites, rodents, and ticks) may help direct the diagnostic workup.