Advanced Tropical Fever Panel

Bacterial/ Viral

8 parameters

Report in 48Hrs

At Home

No Fasting Required

Details

RT-PCR panel for dengue, malaria, chikungunya, etc.

₹7,999₹10,490

24% OFF

Parameters

List of Tests
- Plasmodium spp.
- Dengue virus
- Salmonella spp.
- Chikungunya virus
- Leptospira spp.
- Zika virus
- West Nile virus
- Rickettsia spp.

Advanced Tropical Fever Panel

Why is it done?
- The Advanced Tropical Fever Panel is a comprehensive diagnostic tool designed to identify multiple etiologic agents causing fever in tropical and subtropical regions or travelers returning from endemic areas
- Plasmodium spp.: Detects malaria parasites to diagnose malaria infection, which presents with cyclic fevers, chills, and hemolysis affecting blood cell counts
- Dengue virus: Identifies dengue infection, a mosquito-borne illness causing sudden fever, severe joint pain, and potential hemorrhagic complications
- Salmonella spp.: Diagnoses enteric infections and bacteremia associated with typhoid fever, particularly in endemic regions
- Chikungunya virus: Detects chikungunya infection characterized by sudden fever, severe joint pain, and myalgia lasting weeks to months
- Leptospira spp.: Identifies leptospirosis, a zoonotic disease transmitted through contaminated water, causing biphasic fever and potential renal/hepatic dysfunction
- Zika virus: Detects Zika infection, notable for causing fever, rash, and potential neurological complications including Guillain-Barré syndrome
- West Nile virus: Identifies West Nile infection with potential for severe neurological manifestations including meningitis and encephalitis
- Rickettsia spp.: Diagnoses rickettsial infections such as Rocky Mountain spotted fever and African tick bite fever, transmitted by arthropod vectors
- Recommended for patients presenting with fever of unknown origin (FUO) in tropical settings, recent travel to endemic regions, or suspected exposure to vector-borne pathogens
- Best performed during acute febrile phase (typically first 3-7 days of illness) when pathogen load is highest, though timing varies by organism
Normal Range
- Plasmodium spp.: Negative or no parasites detected on blood smear; quantitative PCR <0.1 parasites/µL (or 0 parasites/µL on microscopy)
- Dengue virus: Negative (IgM and IgG antibodies negative; NS1 antigen negative); RNA not detected on RT-PCR
- Salmonella spp.: Negative; no growth on culture; serology negative (Widal test O and H antibodies <1:80 or negative)
- Chikungunya virus: Negative (IgM and IgG antibodies negative); RNA not detected on RT-PCR
- Leptospira spp.: Negative; no growth on culture; MAT (Microscopic Agglutination Test) titer <1:100 or <1:200 depending on endemic baseline
- Zika virus: Negative (IgM and IgG antibodies negative); RNA not detected on RT-PCR
- West Nile virus: Negative (IgM and IgG antibodies negative); RNA not detected on RT-PCR
- Rickettsia spp.: Negative; no growth on culture; serology negative (antibody titer <1:64 or negative on immunofluorescence)
- Interpretation summary: All individual tests returning negative results indicate absence of detectable pathogenic infection; positive results require clinical correlation with symptoms and epidemiological exposure history
Interpretation
- Plasmodium spp. Positive: Confirms malaria diagnosis; parasite density correlates with disease severity (uncomplicated malaria <100,000/µL; severe malaria typically >250,000/µL); species identification guides treatment selection
- Dengue virus Positive: IgM positivity indicates acute/recent infection; IgG indicates past exposure or immunity; NS1 antigen positivity in first 3-5 days suggests acute phase; PCR positivity confirms active viremia
- Salmonella spp. Positive: Blood culture positive indicates bacteremia/enteric fever; Widal test O antigen ≥1:160 or rising titer suggests typhoid; H antigen elevation suggests previous infection or vaccination
- Chikungunya virus Positive: IgM positivity indicates acute infection (present 3-5 days after symptom onset); IgG indicates past exposure; PCR positivity confirms active viremia during first week of illness
- Leptospira spp. Positive: MAT titer ≥1:400 or fourfold rise between acute and convalescent sera confirms leptospirosis; IgM positivity appears after first week; PCR positivity during first week of illness supports diagnosis
- Zika virus Positive: IgM positivity indicates acute/recent infection; PCR positivity confirms active viremia (typically positive within first week); cross-reactivity with dengue may occur in endemic areas
- West Nile virus Positive: IgM positivity indicates acute infection; IgG indicates past exposure; PCR positivity confirms active viremia; CNS involvement (meningitis/encephalitis) indicated by CSF IgM positivity with neurological symptoms
- Rickettsia spp. Positive: Serology ≥1:64 or fourfold rise in titer confirms rickettsial infection; PCR during first week supports diagnosis; immunofluorescence provides species-specific identification
- Multiple positive results possible: Coinfection with multiple pathogens can occur in endemic regions, requiring comprehensive treatment approach
- False positives: Cross-reactivity between related viruses (dengue/Zika), residual antibodies from previous infections, or non-specific serology requires confirmatory testing with PCR or culture
- False negatives possible if: Testing performed too early (pre-antibody formation), improper specimen handling, or insufficient pathogen load; repeat testing recommended if clinical suspicion remains high
Associated Organs
- Plasmodium spp.: Primarily affects blood (hemolysis, anemia), liver (hepatomegaly, cirrhosis in chronic cases), brain (cerebral malaria with seizures), kidneys (acute kidney injury), and lungs (acute respiratory distress syndrome); complications include multi-organ failure
- Dengue virus: Affects blood (thrombocytopenia, hemorrhage), vascular endothelium (increased permeability), liver (hepatitis), lungs (pulmonary edema), heart (myocarditis), and kidneys; dengue hemorrhagic fever involves severe plasma leakage and coagulopathy
- Salmonella spp.: Affects gastrointestinal tract (enteritis, perforation), blood (bacteremia), liver (hepatomegaly, cirrhosis), spleen (splenomegaly), and immune system; complications include osteomyelitis, endocarditis, and meningitis
- Chikungunya virus: Affects joints (arthralgia, arthritis), muscles (myalgia), skin (rash), and immune system; chronic polyarthralgias can persist months to years affecting quality of life
- Leptospira spp.: Affects kidneys (acute kidney injury, interstitial nephritis), liver (hepatitis, jaundice), lungs (hemorrhage, respiratory failure), heart (myocarditis), brain (meningitis), and blood (coagulopathy); severe form (Weil disease) involves multi-organ failure
- Zika virus: Affects nervous system (Guillain-Barré syndrome, meningitis, encephalitis), reproductive system (birth defects including microcephaly when acquired during pregnancy), skin (rash), and immune system
- West Nile virus: Affects nervous system (meningitis, encephalitis with potential long-term neurological sequelae), blood (viremia), muscles (weakness, paralysis), and immune system; severe neuroinvasive disease carries significant morbidity
- Rickettsia spp.: Affects vascular endothelium (vasculitis), skin (rash, eschar), kidneys (acute kidney injury), brain (encephalitis), heart (myocarditis), and lungs (pneumonia); untreated infections can progress to multi-organ failure and death
- Systemic manifestations: All pathogens typically cause fever, elevated inflammatory markers (CRP, ESR), and constitutional symptoms; prolonged high fever warrants investigation for complications
Follow-up Tests
- Plasmodium spp. Positive: Thick and thin blood smears for parasite quantification and species confirmation; retinopathy examination (ophthalmology) for cerebral malaria; glucose, renal function, liver function tests; lactate levels; blood culture to rule out bacteremia; repeat parasitemia monitoring every 24-48 hours during treatment; monthly Plasmodium testing if residual parasites suspected
- Dengue virus Positive: Platelet count, hematocrit trending for hemorrhagic progression; coagulation profile (PT, aPTT); liver function tests (AST, ALT, bilirubin); viral load by PCR if severe dengue suspected; imaging (ultrasound) for plasma leakage/ascites; daily monitoring during critical phase (days 3-7); repeat serology at 2-4 weeks if initial testing during window period
- Salmonella spp. Positive: Blood culture confirmation; stool culture; urine culture (to identify chronic carriers); susceptibility testing for antibiotic selection; liver function tests; abdominal imaging if perforation suspected; repeat cultures post-treatment to confirm clearance; for chronic carriers, repeat testing at 1, 3, and 12 months
- Chikungunya virus Positive: Joint imaging (ultrasound, X-ray) if persistent arthritis; rheumatoid factor and anti-CCP antibodies to exclude rheumatoid arthritis; HLA-B27 if chronic polyarthritis develops; inflammatory markers (CRP, ESR); repeat serology at 2-4 weeks for confirmation; follow-up at 3-6 months if arthralgia persists
- Leptospira spp. Positive: Creatinine, BUN, urine analysis with microscopy; liver function tests; coagulation profile; CSF analysis if meningitis suspected; chest X-ray if pulmonary involvement; blood culture during first week; repeat MAT at 2-4 weeks for convalescent titer; weekly monitoring of renal function during acute phase; dialysis if acute kidney injury develops
- Zika virus Positive: Ultrasound if pregnancy (assess for microcephaly, other fetal abnormalities); CSF analysis if neurological symptoms present; electromyography if Guillain-Barré syndrome suspected; immunological workup; repeat serology at 2-4 weeks; neurological follow-up if acute neuroinvasive disease; pregnancy monitoring at regular intervals if maternal infection
- West Nile virus Positive: CSF analysis (protein, glucose, cell count, IgM) if neurological symptoms; MRI brain if encephalitis or meningitis suspected; electromyography if paralysis present; repeat serology at 2-4 weeks; neurological assessment at baseline and follow-up; long-term neurological monitoring for sequelae
- Rickettsia spp. Positive: Skin biopsy with immunofluorescence for species-specific identification; blood culture; PCR confirmation; liver function tests; renal function; coagulation profile; chest X-ray if pulmonary involvement; repeat serology at 2-4 weeks; clinical reassessment to ensure therapeutic response
- General recommendations: Complete blood count with differential; comprehensive metabolic panel; lactate; C-reactive protein; procalcitonin; blood cultures; repeat testing if initial results equivocal; paired acute and convalescent sera collected 2-4 weeks apart strengthens serological diagnoses
Fasting Required?
- Fasting Required: No - The Advanced Tropical Fever Panel does not require fasting; specimens can be collected at any time of day
- Blood specimen type: Venous whole blood (EDTA tube for molecular testing); serum separator tubes for serology; EDTA blood film slides for Plasmodium microscopy
- Optimal timing: Perform testing during acute febrile phase (first 3-7 days) when pathogen load is highest; collection during peak fever yields best diagnostic sensitivity
- Specimen handling: Specimens must be transported to laboratory immediately; refrigerate if delay anticipated (do not freeze unless specifically instructed); EDTA tubes for molecular testing must not be hemolyzed
- Medications: No specific medications need to be withheld before testing; however, antimalarial or antibiotic therapy initiated before testing may affect parasite detection or culture growth
- Dietary restrictions: None - Normal diet and fluids can be consumed before testing
- Patient preparation: No special preparation required; patients should be adequately hydrated; inform healthcare provider if antimalarial or antibiotic treatment already initiated
- Contraindications: No absolute contraindications to blood collection; exercise caution in patients with severe thrombocytopenia (dengue hemorrhagic fever, malaria complications)
- Special considerations: Repeat testing recommended if initial results negative but clinical suspicion high; convalescent serology collected 2-4 weeks later improves diagnostic sensitivity for some pathogens

How our test process works!