Opportunities and Challenges to Accurate Diagnosis and Management of Acute Febrile Illness in Adults and Adolescents: A Review

Acta Tropica ◽  
2021 ◽  
pp. 106286
Author(s):  
Brian S Grundy ◽  
Eric R Houpt
2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
L. S. Yong ◽  
K. C. Koh

Concurrent infections with more than one etiological agent can result in an illness with overlapping symptoms, resulting in a situation where the diagnosis and management of such a patient could be challenging. We report a case ofvivaxmalaria in a patient who was also serologically positive for leptospirosis and dengue.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e045826
Author(s):  
Arjun Chandna ◽  
Endashaw M Aderie ◽  
Riris Ahmad ◽  
Eggi Arguni ◽  
Elizabeth A Ashley ◽  
...  

IntroductionIn rural and difficult-to-access settings, early and accurate recognition of febrile children at risk of progressing to serious illness could contribute to improved patient outcomes and better resource allocation. This study aims to develop a prognostic clinical prediction tool to assist community healthcare providers identify febrile children who might benefit from referral or admission for facility-based medical care.Methods and analysisThis prospective observational study will recruit at least 4900 paediatric inpatients and outpatients under the age of 5 years presenting with an acute febrile illness to seven hospitals in six countries across Asia. A venous blood sample and nasopharyngeal swab is collected from each participant and detailed clinical data recorded at presentation, and each day for the first 48 hours of admission for inpatients. Multianalyte assays are performed at reference laboratories to measure a panel of host biomarkers, as well as targeted aetiological investigations for common bacterial and viral pathogens. Clinical outcome is ascertained on day 2 and day 28.Presenting syndromes, clinical outcomes and aetiology of acute febrile illness will be described and compared across sites. Following the latest guidance in prediction model building, a prognostic clinical prediction model, combining simple clinical features and measurements of host biomarkers, will be derived and geographically externally validated. The performance of the model will be evaluated in specific presenting clinical syndromes and fever aetiologies.Ethics and disseminationThe study has received approval from all relevant international, national and institutional ethics committees. Written informed consent is provided by the caretaker of all participants. Results will be shared with local and national stakeholders, and disseminated via peer-reviewed open-access journals and scientific meetings.Trial registration numberNCT04285021.


Author(s):  
Vladimir G. Dedkov ◽  
N’Faly Magassouba ◽  
Olga A. Stukolova ◽  
Victoria A. Savina ◽  
Jakob Camara ◽  
...  

Acute febrile illnesses occur frequently in Guinea. Acute fever itself is not a unique, hallmark indication (pathognomonic sign) of any one illness or disease. In the infectious disease context, fever’s underlying cause can be a wide range of viral or bacterial pathogens, including the Ebola virus. In this study, molecular and serological methods were used to analyze samples from patients hospitalized with acute febrile illness in various regions of Guinea. This analysis was undertaken with the goal of accomplishing differential diagnosis (determination of causative pathogen) in such cases. As a result, a number of pathogens, both viral and bacterial, were identified in Guinea as causative agents behind acute febrile illness. In approximately 60% of the studied samples, however, a definitive determination could not be made.


Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 422
Author(s):  
Rajendra Gautam ◽  
Keshab Parajuli ◽  
Mythili Tadepalli ◽  
Stephen Graves ◽  
John Stenos ◽  
...  

Scrub typhus is a vector-borne, acute febrile illness caused by Orientia tsutsugamushi. Scrub typhus continues to be an important but neglected tropical disease in Nepal. Information on this pathogen in Nepal is limited to serological surveys with little information available on molecular methods to detect O. tsutsugamushi. Limited information exists on the genetic diversity of this pathogen. A total of 282 blood samples were obtained from patients with suspected scrub typhus from central Nepal and 84 (30%) were positive for O. tsutsugamushi by 16S rRNA qPCR. Positive samples were further subjected to 56 kDa and 47 kDa molecular typing and molecularly compared to other O. tsutsugamushi strains. Phylogenetic analysis revealed that Nepalese O. tsutsugamushi strains largely cluster together and cluster away from other O. tsutsugamushi strains from Asia and elsewhere. One exception was the sample of Nepal_1, with its partial 56 kDa sequence clustering more closely with non-Nepalese O. tsutsugamushi 56 kDa sequences, potentially indicating that homologous recombination may influence the genetic diversity of strains in this region. Knowledge on the circulating strains in Nepal is important to the development of diagnostic tests and vaccines to support public health measures to control scrub typhus in this country.


CHEST Journal ◽  
1999 ◽  
Vol 116 (5) ◽  
pp. 1452-1458 ◽  
Author(s):  
Susanna Von Essen ◽  
Jon Fryzek ◽  
Bogdan Nowakowski ◽  
Mary Wampler

1987 ◽  
Vol 32 (5) ◽  
pp. 149-150
Author(s):  
J. Hamilton ◽  
R.A. Sharp ◽  
J. M. Anderson ◽  
M. R. Kerr

Inflammatory polymyositis can be precipitated by acute febrile illness of viral origin1, but similar association with pyogenic bacterial illness is not recognised. We describe two cases in which recovery from staphylococcal septicaemia was complicated by a widespread inflammatory myopathy.


PEDIATRICS ◽  
1994 ◽  
Vol 93 (3) ◽  
pp. 525-528
Author(s):  
Julie Kim Stamos ◽  
Kathleen Corydon ◽  
James Donaldson ◽  
Stanford T. Shulman

Kawasaki disease (KD) is an acute febrile illness primarily affecting infants and young children. Its importance relates to the fact that 20% to 25% of untreated patients develop coronary abnormalities that can lead to myocardial infarction or even to death.1 KD is a leading cause of acquired heart disease in children in many regions, including the United States.2 Because there are no specific diagnostic tests for KD, the diagnosis is established by the presence of fever and four of five criteria without other explanation for the illness: (1) nonexudative conjunctival injection; (2) oral mucosal changes; (3) changes of the peripheral extremities; (4) rash, primarily truncal; and (5) cervical lymphadenopathy.


2011 ◽  
Vol 4 (1) ◽  
pp. 15-20
Author(s):  
RG Aiyer ◽  
Rahul Gupta ◽  
Prarthna S Dhameja ◽  
Virag Damania ◽  
Abhishek Sharma ◽  
...  

ABSTRACT Sphenoid sinus lesions can present with a multitude of symptoms/signs including ophthalmic disturbances. We describe a total of five patients, of which two had mucoceles and rest three had fungal infection. Ophthalmic symptoms/signs were the ones we were really interested in. We also present one case which had isolated sphenoid fungal sinus. We also give details of their presentation, investigations and treatment. Possible ocular manifestations of mucoceles and the diagnostic imaging techniques used are discussed. The treatment of mucoceles is reviewed. It is stressed that a team approach involving the ophthalmologist, otolaryngologist and radiologist is essential for accurate diagnosis and management.


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