title: Acute undifferentiated fever caused by infection with Japanese encephalitis virus.
abstract: To determine the proportion of acute undifferentiated fevers without neurologic deficits related to infection with Japanese encephalitis (JE) virus, flavivirus serology (dengue and JE) was performed in a cohort of 156 adults presenting to a hospital in Chiangrai, Thailand. Recent flavivirus infection was diagnosed for any individual with an IgM result > 40 units. A ratio of dengue virus IgM to JE virus IgM < 0.91 defined a JE virus infection. Diagnostic criteria for Japanese encephalitis were met in 22 individuals (14%), and were unequivocal in 8 patients. The admission findings in these eight subjects were similar to those described for other flavivirus infections. Thrombocytopenia was the most striking laboratory abnormality (median platelet count = 119,000/mm3, range = 44,000-236,000/mm3). Headache (75%), nausea (50%), myalgia (38%), rash (38%), and diarrhea (25%) were the most frequently encountered signs and symptoms. Infection with Japanese encephalitis virus is an underappreciated cause of acute undifferentiated fever in Asia.
authors.affiliation: Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand. wattgh@thai.amedd.army.mil
authors.forename: George
authors.initials: G
authors.lastname: Watt
authors.forename: Krisada
authors.initials: K
authors.lastname: Jongsakul
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D003715:Dengue / Q000175:diagnosis; D003716:Dengue Virus / Q000276:immunology; D004664:Encephalitis Virus, Japanese / Q000276:immunology*; D004672:Encephalitis, Japanese / Q000175:diagnosis* / Q000821:virology; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D013785:Thailand
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M