Middle East Respiratory Syndrome (MERS) Differential Diagnoses

Updated: Jun 22, 2015
  • Author: Diana M Salazar, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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DDx

Diagnostic Considerations

Patients who present with fevers, chills, myalgias, rhinorrhea, and pneumonia or who develop acute respiratory distress syndrome and have a history of travel to countries in or near the Arabian Peninsula within the past 14 days should be evaluated for Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) infection. Also, patients who have had close contact with a symptomatic traveler from this region or close contact with a confirmed or probable case should be evaluated for MERS-CoV infection.

In addition, a patient presenting with fever and pneumonia or acute respiratory distress syndrome should be evaluated for MERS if he or she had been a patient, worker, or visitor in a South Korean healthcare facility within 14 days of symptom onset. [8]

Clinical overlap may be seen with other viruses that manifest with flulike symptoms, and a proper clinical, epidemiological, and diagnostic evaluation should be performed.

Differentials

Influenza virus infection

Parainfluenza virus infection

Respiratory syncytial virus (RSV) infection

Adenovirus infection

Rhinovirus infection

Infection with other coronaviruses, including HC0V-OC43 and HCoV-229E, organisms responsible for the common cold

Metapneumovirus infection

Acute respiratory distress syndrome

Community-acquired pneumonia

Brucellosis