Differential Diagnosis for Pregnant Woman with Multiple Mosquito Bites
Single Most Likely Diagnosis
- Zika Virus Infection: This diagnosis is the most likely due to the symptoms of fever, arthralgias, conjunctivitis, and the history of multiple mosquito bites in the first trimester. Zika virus infection during pregnancy is known to cause congenital Zika syndrome, which can lead to severe birth defects, including microcephaly. The mention of low radial glands neural precursor cells also points towards a possible impact on fetal neural development, a hallmark of Zika infection.
Other Likely Diagnoses
- Chikungunya: This is another mosquito-borne illness that can cause fever, arthralgias, and conjunctivitis. While it's less commonly associated with birth defects compared to Zika, it can still cause significant morbidity in pregnant women and potentially affect the fetus.
- Dengue Fever: Although primarily known for causing hemorrhagic fever, dengue can also present with fever, arthralgias, and conjunctivitis. The risk to the fetus is generally lower than with Zika but can still cause complications in pregnancy.
Do Not Miss Diagnoses
- Malaria: While less likely given the symptoms, malaria is a mosquito-borne disease that can be deadly if not treated promptly. It's crucial to consider, especially if the patient has been in an area where malaria is endemic. Malaria in pregnancy can increase the risk of maternal and fetal morbidity and mortality.
- West Nile Virus: This virus can cause a range of symptoms from mild fever to severe neurological diseases. Although less commonly associated with congenital abnormalities, its potential for severe outcomes makes it a "do not miss" diagnosis.
Rare Diagnoses
- Mayaro Virus: A less common mosquito-borne virus that can cause fever, arthralgias, and in some cases, conjunctivitis. It's rare but could be considered in the differential diagnosis, especially if other tests are negative and the clinical presentation fits.
- Rift Valley Fever: This zoonotic disease can be transmitted by mosquitoes and is known to cause severe disease in humans, including hemorrhagic fever and encephalitis. It's rare and typically associated with exposure to infected animals, but it could be considered in specific epidemiological contexts.