![]() ![]() ![]() 9, 14 – 20 Various general symptoms and signs have been associated with acute human infection, and encephalitis and retinal vasculitis have been described as late RVF complications. 8 – 13 The spectrum of RVF symptoms ranges from a mild, self-limited illness to a potentially fatal hemorrhagic disease. 3, 7 Epidemic RVF has been documented throughout sub-Saharan Africa as well as in Egypt and the Arabian Peninsula. 6 There are also data to suggest the virus is transmitted at low levels between epizootic/epidemic outbreaks. Then, if sufficiently widespread, the epizootic will be followed by case reports of symptomatic RVF among humans. 4, 5 Typically, floodwater mosquito-borne viral transmission first reintroduces RVFV and causes RVF outbreaks among animals. 3 During outbreaks, aerosols of virus-containing materials can also transmit infection. 2 Numerous species of mosquitoes, particularly of the genera Aedes and Culex, can transmit the virus, and epizootics and epidemics of RVF often occur after episodes of flooding in areas where RVFV has transmitted in the past. 1 The RVFV-associated disease, RVF, was initially described in 1931 as a livestock illness of sheep and cattle and shortly thereafter, as a symptomatic human infection among pastoralists and laboratory personnel exposed to infected animal materials. Rift Valley fever (RVF) virus (RVFV) is a negative sense, segmented genome RNA virus of the family Bunyaviridae, which was first isolated from ill sheep in the Rift Valley District of Kenya. Further characterization of a distinct RVF clinical syndrome will aid earlier detection of RVF outbreaks and should allow more rapid implementation of control. ![]() Our data reveal an identifiable clinical syndrome suggestive of severe RVF, characterized by fever, large-joint arthralgia, and gastrointestinal complaints and later followed by jaundice, right upper-quadrant pain, and delirium, often coinciding with hemorrhagic manifestations. In 2007, a Kenyan outbreak of RVF provided opportunity to assess acutely ill RVF patients and better delineate its presentation and clinical course. Although general signs and symptoms of human RVF have been documented, a specific clinical syndrome has not been described. Outbreaks of RVF, like other diseases caused by hemorrhagic fever viruses, typically present in locations with very limited health resources, where initial diagnosis must be based only on history and physical examination. CT abd.Rift Valley fever (RVF) virus is an emerging pathogen that is transmitted in many regions of sub-Saharan Africa, parts of Egypt, and the Arabian peninsula. with flexion of abdominal muscles (hernia) Pelvic - cervical discharge, cervical motion tenderness Genital (high-riding testis with loss of cremasteric reflex-testicular torsion) Rectal - tenderness LABS: UCG, CBC with diff, CMP, urinalysis Imaging: *If patient pregnant → US *Suspected appendicitis → usu. Prior STD- risk of PID LMP, any possibility of pregnancy *PE: Vitals - fever Abdomen - tenderness, peritoneal signs (rebound, guarding), tenderness, special tests (Rosvings, Obturator, Psoas), CVA (pyelo) tenderness, palpable defect - esp. symptoms - fever, flank pain, urinary symptoms, hematuria, vaginal discharge or bleeding, change in bowel habits, hematochezia *PMH Past surgeries - ? tubal ligation: ectopic preg. ![]() DDX: appendicitis, salpingitis (PID), torsion, ectopic pregnancy, inguinal hernia, nephrolithiasis, IBD HX: Radiation or migration of pain (has it been consistently the RLQ), is pain sharp / stabbing Aggravating / Alleviating factors - does movement aggravate pain, eating / appetite Assoc. ![]()
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