History:
Exposure risk factors: animal herders, livestock workers, slaughterhouse workers, and healthcare workers in endemic areas
Incubation period usually lasts less than one week from exposure
Sudden onset of: headache, high fever, back/joint/stomach pain, vomiting, photophobia
Mood swing and confusion develop after initial symptoms, followed by sleepiness and depression.
Abdominal pain migrates to RUQ
Physical Exam:
Conjunctivitis, facial flushing, palatal erythema and petechiae, lymphadenopathy,
Jaundice and changes in mood and sensory perception
Signs of coagulopathy (starting around day 4)
Palpable hepatomegaly
Clinical Course: Estimated 9-50% mortality
Crimean-Congo hemorrhagic fever
Normal causes of acute fever!
Rocky mountain spotted fever
Malaria
Drug fever
Dengue
Typhoid fever
Leptospirosis