Differential Diagnosis for Travel to Central America with Fevers and Myalgias
Single Most Likely Diagnosis
- Dengue Fever: This is a common illness in Central America, transmitted by mosquitoes, and characterized by high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, and mild bleeding.
Other Likely Diagnoses
- Zika Virus: Similar to dengue, Zika is transmitted by mosquitoes and can cause fever, rash, joint pain, and conjunctivitis. Its presence in Central America makes it a likely consideration.
- Chikungunya: Another mosquito-borne illness prevalent in Central America, characterized by sudden onset of fever and severe joint pain.
- Influenza: While not exclusive to Central America, influenza can cause similar symptoms and should be considered, especially during flu season.
Do Not Miss Diagnoses
- Malaria: Although less common in some parts of Central America, malaria is a potentially deadly disease transmitted by mosquitoes. It causes periodic fevers, chills, and flu-like symptoms.
- Leptospirosis: This bacterial infection can be contracted through water exposure and causes fever, headache, and muscle aches. It's crucial to consider in travelers who have been swimming or wading in freshwater.
- Typhoid Fever: Caused by Salmonella Typhi, this illness is more common in areas with poor sanitation. It presents with prolonged fever, headache, nausea, loss of appetite, and abdominal pain.
Rare Diagnoses
- Venezuelan Equine Encephalitis (VEE): A viral disease transmitted by mosquitoes, which can cause severe symptoms including fever, headache, and encephalitis.
- Hantavirus: While more commonly associated with the southwestern United States, some strains of hantavirus are found in Central America. It can cause hantavirus pulmonary syndrome (HPS), a severe and sometimes fatal respiratory disease.
- Rickettsial Diseases: Such as Rocky Mountain spotted fever, which can be found in Central America and causes fever, headache, and rash.