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​Symptoms and Signs – Differential Diagnosis of Fever and Jaundice
• Yersinia infection, leptospirosis, yellow fever, dengue fever, relapsing fever
• Viral hepatitis
• Toxic shock syndrome
• Sepsis
• Pancreatitis
• Neoplasm (hepatic, pancreatic, biliary tract, metastatic)
• Mononucleosis
• Malaria
• HIV infection (Cryptosporidium)
• Hepatic abscess (pyogenic, amebic)
• Cholecystitis
• Biliary ascariasis
• Babesiosis
• Ascending cholangitis
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​Symptoms and Signs – Differential Diagnosis of Fever and Rash
• Viral infection: measles, rubella, varicella, erythema infectiosum, roseola, enterovirus infection, viral hepatitis, infectious mononucleosis, acute HIV infection
• Systemic lupus erythematosus (SLE)
• Serum sickness
• Pityriasis rosea
• Other infections: meningococcemia, staphylococcemia, scarlet fever, typhoid fever, Pseudomonas bacteremia, Rocky Mountain spotted fever, Lyme disease, secondary syphilis, bacterial endocarditis, babesiosis, brucellosis, listeriosis
• Herpes zoster
• Erythema nodosum
• Erythema multiforme
• Erythema marginatum
• Drug hypersensitivity: penicillin, sulfonamides, thiazides, anticonvulsants, allopurinol
• Dermatomyositis
• Allergic vasculitis
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​Symptoms and Signs – Differential Diagnosis of Fever in Returning Travelers and Immigrants
Differential diagnosis of some selected systemic febrile illnesses to
consider in returned travelers and immigrants*
COMMON
• Acute respiratory tract infection (worldwide)
• Gastroenteritis (worldwide) [food-borne, water-borne, fecal-oral]
• Enteric fever, including typhoid (worldwide) [food, water]
• Urinary tract infection (worldwide) [sexual contact]
• Drug reactions [antibiotics, prophylactic agents, other] {rash
frequent}
• Malaria (tropics, limited areas of temperate zones) [mosquitoes]
• Arboviruses (Africa, tropics) [mosquitoes, ticks, mites]
• Dengue (Asia, Caribbean, Africa) [mosquitoes]
• Viral hepatitis (worldwide)
• Hepatitis A (worldwide) [food, fecal-oral]
• Hepatitis B (worldwide, especially Asia, sub-Saharan Africa)
[sexual contact] {long incubation period}
• Hepatitis C (worldwide) [blood or sexual contact]
• Hepatitis E (Asia, North Africa, Mexico, others) [food, water]
• TB (worldwide) [airborne, milk] {long period to symptomatic
infection}
• STDs (worldwide) [sexual contact]
LESS COMMON
• Filariasis (Asia, Africa, South America) [biting insects] {long
incubation period, eosinophilia}
• Measles (developing world) [airborne] {in susceptible individual}
• Amebic abscess (worldwide) [food]
• Brucellosis (worldwide) [milk, cheese, food, animal contact]
• Listeriosis (worldwide) [food-borne] {meningitis}
• Leptospirosis (worldwide) [animal contact, open fresh water]
{jaundice, meningitis}
• Strongyloidiasis (warm and tropical areas) [soil contact]
{eosinophilia}
• Toxoplasmosis (worldwide) [undercooked meat]
RARE
• Relapsing fever (western Americas, Asia, northern Africa) [ticks,
lice]
• Hemorrhagic fevers (worldwide) [arthropod and nonarthropod
transmitted]
• Yellow fever (tropics) [mosquitoes] {hepatitis}
• Hemorrhagic fever with renal syndrome (Europe, Asia, North
America) [rodent urine] {renal impairment}
• Hantavirus pulmonary syndrome (western North America, others)
[rodent urine] {respiratory distress syndrome}
• Lassa fever (Africa) [rodent excreta, person to person] {high
mortality rate}
• Other: chikungunya, Rift Valley, Ebola-Marburg, others (various)
[insect bites, rodent excreta, aerosols, person to person] {often
severe}
• Rickettsial infections {rashes and eschars}
• Leishmaniasis, visceral (Middle East, Mediterranean, Africa, Asia,
South America) [biting flies] {long incubation period}
• Acute schistosomiasis (Africa, Asia, South America, Caribbean)
[fresh water]
• Chagas’ disease (South and Central America) [reduviid bug bites]
{often asymptomatic}
• African trypanosomiasis (Africa) [tsetse fly bite] {neurologic
syndromes, sleeping sickness}
• Bartonellosis (South America) [sandfly bite; cb] {skin nodules}
• HIV infection/AIDS (worldwide) [sexual and blood contact]
• Trichinosis (worldwide) [undercooked meat] {eosinophilia}
• Plague (temperate and tropical plains) [animal exposures and
fleas]
• Tularemia (worldwide) [animal contact, fleas, aerosols] {ulcers,
lymph nodes}
• Anthrax (worldwide) [animal, animal product contact] {ulcers}
• Lyme disease (North America, Europe) [tick bites] {arthritis,
meningitis, cardiac abnormalities}
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​Symptoms and Signs – Differential Diagnosis of Fever of Undetermined Origin (FUO)
• Infection (16%)
• Abscess: abdominal, pelvic
• Tuberculosis
• HIV infection
• Nosocomial (febrile for 3 days in hospital): urinary tract
infection, pneumonia, line-related bacteremia, Clostridium
difficile diarrhea, sinusitis
• Bacterial endocarditis (especially caused by difficult-to-isolate
organisms)
• Biliary tract infection
• Osteomyelitis, vertebral and mandibular
• Less common infections: Q fever, leptospirosis, psittacosis,
tularemia, secondary syphilis, gonococcemia, chronic
meningococcemia, Whipple’s disease, yersiniosis, fungal
infections

• Malignant neoplasia (7%)
• Lymphoma and leukemia, renal cell carcinoma, hepatocellular
carcinomas, other tumors metastatic to liver
• Noninfectious inflammatory disease (22%)
• Juvenile rheumatoid arthritis (younger patients)
• Temporal arteritis (elderly patients)
• Other vasculitis: polyarteritis nodosa, Takayasu’s arteritis,
Wegener’s granulomatosis, mixed cryoglobulinemia, adult
Still’s disease

• Other (4%)
• Drug-induced fever
• Inflammatory bowel disease
• Sarcoidosis
• Granulomatous hepatitis
• Deep venous thrombosis
• Alcoholic hepatitis
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​Symptoms and Signs – Differential Diagnosis of Fibrocystic Breast Disease
• Mastodynia
• Mastitis
• If presenting with nipple discharge, differentiate from discharge of possible malignant origin
• If presenting as dominant mass or masses, exclude possible carcinoma
• Breast abscess
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​Symptoms and Signs – Differential Diagnosis of Fibromyalgia
• Polymyalgia rheumatica
• Referred discogenic spine pain
• Rheumatoid arthritis (RA)
• Localized tendinitis
• Connective tissue disease
• Osteoarthritis
• Thyroid disease
• Spondyloarthropathies
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​Symptoms and Signs – Differential Diagnosis of Fifth Disease
• Rubella, measles (rubeola), and other childhood viral exanthems
• Mononucleosis
• Lyme disease
• Juvenile rheumatoid arthritis (JRA) (Still’s disease)
• Drug eruption
• Acute HIV infection
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​Symptoms and Signs – Differential Diagnosis of Facial Paralysis
INFECTION
• Bacterial: otitis media, mastoiditis, meningitis, Lyme disease
• Viral: herpes zoster, mononucleosis, varicella, rubella, mumps,
Bell’s palsy
• Mycobacterial: TB, meningitis, leprosy
• Miscellaneous: syphilis, malaria
TRAUMA
• Temporal bone fracture, facial laceration
• Surgery
NEOPLASM
• Malignant: squamous cell carcinoma, basal cell and adenocystic
tumors, leukemia, parotid neoplasms, metastatic tumors
• Benign: facial nerve neuroma, vestibular schwannoma, congenital
cholesteatoma
IMMUNOLOGIC
• Guillain-Barré syndrome, periarteritis nodosa
• Reaction to tetanus antiserum
METABOLIC
• Pregnancy
• Hypothyroidism
• Diabetes mellitus (DM)
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Kembara Xtra 

Facts about medicine and its subtopic such as anatomy, physiology, biochemistry, pharmacology, medicine, pediatrics, psychiatry, obstetrics and gynecology and surgery.