Boutonneuse Fever Differential Diagnoses

Updated: Mar 11, 2016
  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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DDx

Diagnostic Considerations

The malignant form of boutonneuse fever (BF) is diagnosed on the basis of specific combinations of laboratory findings and clinical symptoms.

Laboratory findings indicative of malignant BF when combined with clinical symptoms (see below), are as follows (≥2 required):

  • Thrombocytopenia (< 100 X 109/L)

  • Renal failure (creatinine level >150 mmol/L)

  • Hyponatremia (< 130 mmol/L)

  • Hypocalcemia (< 2.1 mmol/L)

  • Hypoxemia (arterial oxygen pressure < 80 mm Hg)

Clinical symptoms indicative of malignant BF when combined with laboratory findings (see above), are as follows (≥2 required):

  • Purpuric rash

  • Stupor

  • Pneumonia

  • Bradycardia

  • Coma

  • Jaundice

  • Gastrointestinal bleeding

  • Arthralgic and myalgic arthritis

  • Hepatomegaly and splenomegaly

  • Orchitis

  • Conjunctival hyperemia

  • Meningism [18]

  • Meningitis

  • Local lymphadenopathy

In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:

  • Hepatitis

  • Aseptic acute arthritis

  • Small-vessel vasculitis

  • Sepsis

Differentials