2nd August 2023

Disease Presentations

A ‘Fever Plus’ approach, whereby recognising a fever in addition to an acute key symptom such as diarrhoea or rash, can be extremely useful in narrowing down differentials to inform further investigation and management.

Fever Plus ‘x’ Symptom(s)	Pathogens to consider
Maculopapular rash	Dengue, HIV, Syphilis, Zika Virus, Parvovirus B19, Chikungunya, Rickettsia
Diarrhoea +/- vomiting	Shigella, Salmonella (typhoid/paratyphoid), Amoebiasis
Jaundice	Viral hepatitis, Malaria, Leptospirosis, Yellow fever virus
Abdominal pain	Leptospirosis, Enteric fever, Viral hepatitis, Malaria, Visceral leishmaniasis
Seizure/Neurological deficit	Cerebral Malaria, TB meningitis, Cerebral abscess, West Nile Virus, HSV encephalitis, Japanese encephalitis, Tick Borne Encephalitis, cysticercosis, Human African trypanosomiasis
Eschar	Scrub typhus
Haemorrhage	Dengue, Ebola, Yellow fever virus, Marburg, Crimean-Congo haemorrhagic fever (CCHF), Lassa
Shortness of breath +/- cough	SARS-CoV-1 and 2, Influenza, Pneumonia, Tuberculosis, Aspergillosis, Melioidosis, Legionnaire’s coccidioidomycosis, Schistosomiasis

Table 4: A ‘Fever Plus’ approach by key symptom(s)

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