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Differential Diagnosis Between Influenza and Other Respiratory Viral Infections: What Are the Differential Diagnoses?

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Abstract

Respiratory viruses causing seasonal epidemics in the community are called community-acquired respiratory viruses (CARVs). CARVs include RNA viruses such as human rhinovirus, human respiratory syncytial virus, human parainfluenza virus, human coronavirus, human metapneumovirus, human enterovirus, human parechovirus, and DNA viruses such as human adenovirus and human bocavirus. Needless to say, influenza-like illness (ILI) is caused not only by influenza virus but also by other CARVs. Epidemiological studies targeting ILI patients revealed that CARVs other than influenza are universally detected, predominantly the rhinovirus. However, the viral etiology of ILI is affected by many factors such as the study population, season, setting (community or outpatient or inpatient), and regions. Previous studies investigated the utility of fever and cough as clinical diagnosis markers of influenza, nonetheless the sensitivity and specificity were modest. Since CARVs fairly cause respiratory and general symptoms including fever, cough, coryza, sore throat, headache, myalgia, and chills, predicting the causative virus by clinical symptoms is further difficult in most cases, except for diseases presenting with unique features such as laryngotracheobronchitis (croup), herpangina, and hand-foot-and-mouth disease. Consequently, clinical manifestations are not reliable enough for the differential diagnosis between influenza and other CARVs infection, therefore a rapid antigen test or molecular assay is critical to confirm the causative virus.

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  1. Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan

    Takeshi Kinjo & Jiro Fujita

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  1. Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan

    Jiro Fujita

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Kinjo, T., Fujita, J. (2021). Differential Diagnosis Between Influenza and Other Respiratory Viral Infections: What Are the Differential Diagnoses?. In: Fujita, J. (eds) Influenza. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-15-9109-9_8

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