UMEM Educational Pearls

Title: Viral Hemorrhagic Fever

Category: International EM

Keywords: International, Fever, Hemorrhagic (PubMed Search)

Posted: 4/9/2014 by Andrea Tenner, MD
Click here to contact Andrea Tenner, MD

General Information:

Vector transmission – humans, rodents, livestock, bush meat, mosquito, tick, contaminated feces
Incubation of 2-14 days

Clinical Presentation:

Mild – Mod: fever, fatigues, malaise, myalgia followed by coagulopathy (petechial rash)
Severe: shock, coma, delirium, seizure, liver/renal failure

Diagnosis:

Whole blood or serum can be sent to the CDC for testing (PCR, IgM/IgG, viral culture)
Leukopenia/leukocytosis, proteinuria, thrombocytopenia, LFTs/PT/PTT, may see DIC

Treatment:

Supportive
Contact and airborne precautions
Ribavirin – effective in patients with Lassa fever or HFRS (not approved by the FDA)
Convalescent-phase plasma has been used with success in some patients with Argentine hemorrhagic fever
FFP, high dose steroids has been reported to be successful in Crimean-Congo (CCHF)

Bottom Line:

University of Maryland Section of Global Emergency Health

Author: Veronica Pei