Which conditions should be included in the differential diagnoses of influenza?

Updated: Aug 07, 2020
  • Author: Hien H Nguyen, MD, MS; Chief Editor: Michael Stuart Bronze, MD  more...
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Accurately diagnosing influenza A or B infection solely on the basis of clinical criteria is difficult because of the overlapping symptoms caused by the various viruses associated with upper respiratory tract infection (URI). Viruses that may initially cause influenzalike symptoms include adenoviruses, enteroviruses, and paramyxoviruses.

The early presentation of mild or moderate cases of flavivirus infections (eg, dengue) may initially mimic influenza. For example, some cases of West Nile fever acquired in New York in 1999 were clinically misdiagnosed as influenza. [3]

Like influenza, URIs from these viruses are more common in the winter. As a result, during the winter, clinics and emergency department waiting rooms fill with patients who have influenza or other URIs.

Influenza pneumonia must be differentiated from other forms of viral pneumonia, bacterial pneumonia, and noninfectious causes of respiratory distress, such as heart failure, chronic obstructive pulmonary disease, pulmonary edema, and aspiration pneumonitis.

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