The differential diagnosis of Japanese Encephalitis

(A) poisoning bacillary dysentery
The disease found in summer and autumn, Multiple children, the beginning of gastrointestinal disease before symptoms arise can be a high fever and neurological symptoms (coma, convulsions), it easily confused with JE. But this is a disease early shock, the general levy no meningeal irritation, no change in cerebrospinal fluid, feces or enema solution available on the RBC see,and phagocytic cells, cultured with Shigella growth, and Japanese encephalitis can distinguish.
(B) purulent meningitis
JE similar symptoms, but common in winter and spring, the comparatively rapid development of illness, the weight of after 1 to 2 days to enter a coma. ECM can see early bruising points. Streptococcus pneumoniae meningitis, streptococcus meningitis and other bacterial meningitis was particularly prevalent in young children, often with first or pneumonia, otitis media and mastoiditis, sinusitis or purulent skin lesions, and no primary lesion JE . If necessary, available on the cerebrospinal fluid identification.
(C) tuberculous meningitis
A small number of patients with tuberculous meningitis incidence urgent, early in cerebrospinal fluid from time low, in the JE epidemic season easily misdiagnosed, but long-node encephalopathy, tuberculosis or TB lesions contact history, the most positive tuberculin test. Tuberculous meningitis was ground glass-like appearance CSF, IL-based classification to lymphocytes, and the chloride content of reducing sugar, protein can increase; placed there after the cerebrospinal fluid film, smear can be found Mycobacterium tuberculosis.
(D) mumps, polio, coxsackie virus and cyanide can be caused by central nervous system infection
Such patients cerebrospinal fluid interleukin may 0.05 ~ 0.5 × 109 / L, lymphocytes but mainly to classification. Some patients may first appeared mumps meningoencephalitis symptoms occurred after the parotid gland swelling, differential flow gills should be asked to contact history. A small number of JE patients have flaccid paralysis can be easily misdiagnosed as polio, but the latter and unconscious obstacles. Coxsackie virus, cyanide can be viruses, herpes simplex virus, varicella virus can also cause similar symptoms. Information should be based on epidemiology, clinical features and serological examination to be distinguished.
(5) Leptospirosis
The type of the disease - meningitis and encephalitis B confusion, but a history of contact with infected water, fatigue, gastrocnemius muscle pain, conjunctival hyperemia, axillary or inguinal lymphadenopathy, cerebrospinal fluid changes slightly. Serological tests can be used to confirm.
(6) cerebral malaria
Incidence season, the region and with the clinical manifestations were similar to Japanese encephalitis. But cerebral malaria fever-than irregular. Early first of chills, fever and sweating and then there cerebral symptoms. Also anemia and splenomegaly there. Blood-View Plasmodium can be diagnosed.
(7) Other
New cryptococcal meningitis, heat stroke, cerebrovascular accident, subarachnoid hemorrhage, acute cerebral schistosomiasis, such as typhus and septicemia caused by encephalopathy, also according to the pathogenesis, clinical manifestations, as well as laboratory tests, to be Identification.