Version June 2024
| Epidemiologic clues | Potential etiologies |
| Age (0 to 28 days) | Infectious – CMV, HSV (type 1 or 2), enteroviruses, parechoviruses, rubella virus Noninfectious – Inborn error of metabolism (eg, organic acidemia, urea cycle disorder) |
| Season: | |
| Summer | Enterovirus, free-living amebae |
| Late summer/fall | Arbovirus |
| Winter | Postinfectious encephalitis in countries with low rates of MMR immunization |
| Infection in horses, birds | Arbovirus, Hendra virus |
| Blood transfusion or transplant recipient | CMV, EBV, HIV, rabies, tick-borne encephalitis, WNV |
| Immunodeficiency | CMV, HHV-6, HSV, VZV, WNV, enterovirus (especially in X-linked agammaglobulinemia and common variable immunodeficiency) |
| Historic clues | |
| Rash | |
| Vesicular | HSV, VZV, enterovirus (hand, foot, and mouth disease), herpes B virus |
| Hand, foot, mouth | Enterovirus |
| Erythematous macules and papules with cephalocaudad spread | Measles |
| Maculopapular | WNV |
| Maculopapular/petechial begins on ankles and wrists | Rocky Mountain spotted fever |
| Exposures | |
| Mosquitoes | Arbovirus |
| Ticks | Borrelia burgdorferi, Powassan virus, Rickettsia rickettsii, tick-borne encephalitis |
| Animal bite/exposure (dog, bat, cat, birds, livestock, others) | Rabies, arboviruses, cat scratch disease, Q fever |
| Blood transfusion or transplant recipient | CMV, EBV, HIV, rabies, tick-borne encephalitis, WNV |
| Recent infectious illness | ADEM |
| Recreational activity | |
| Swimming | Enteroviruses, free-living amebae |
| Spelunking | Rabies |
| Sexual activity | HIV, Treponema pallidum |
| Travel | |
| Immunization | |
| Lack of immunization for specific agent | Japanese encephalitis, MMR, VZV, polio, tick-borne encephalitis |
| Recent immunization | ADEM |
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