Topic: Dengue, Kala-azar, Japanese Encephalitis
Question: Describe the clinical presentation in dengue fever.
Click here for Reference Material-This material is informational alone and is not specifically prepared as an answer for any question. Readers may do their own research before finalising diagnoses according to the characteristics unique to each question. Readers should not proceed without cross-referencing with relevant textbooks as well as standard guidelines available.
Here is an overview of the typical clinical presentation of dengue fever:
– Onset is abrupt, with high fevers reaching 104-105°F. Fever lasts for 2-7 days.
– Severe headache (especially retro-orbital), myalgias, and arthralgias are common. The muscles and joints can have intense pain.
– A transient macular or maculopapular rash usually appears first on the trunk around 3-4 days after fever onset. It then spreads to face, limbs and palms/soles.
– Facial flushing, sore throat, injected pharynx, and conjunctival injection may be present.
– GI symptoms like nausea, vomiting, abdominal pain, diarrhea may occur.
– Minor mucosal bleeding like nosebleeds or gingival bleeding can occur.
– Low WBC count, thrombocytopenia, atypical lymphocytes on blood smear are common lab findings.
– PETECHIAE and ecchymoses on skin may be seen in moderate/severe cases (dengue hemorrhagic fever).
– Plasma leakage, ascites, pleural effusions can occur in severe cases. Shock occurs in dengue shock syndrome.
– No major neurological, respiratory or cardiac complications are usually seen.
– Recovery is usually complete in 7-10 days once fever subsides. Mortality rate is 1-5% mostly due to plasma leakage and shock
