Middle East Respiratory Syndrome (MERS) Differential Diagnoses

Updated: Dec 15, 2022
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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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. [32]

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


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