Dengue fever

Epidemiology:  ~ 50 million cases per year, mosquito vector disease 

Disease syndrome has clinical variability from asymptomatic infection to dengue hemorrhagic fever with shock syndrome

Incubation period — ranges from 3 to 14 days

Symptoms: fever with marked muscle and joint bains (“break-bone fever”) often followed by fatigue, can also have non-specific rash and GI symptoms

Hemorrhagic manifestations — spontaneous bleeding most commonly on the skin

Physical examination — fever, rash, pharyngeal erythema, lymphadenopathy, hepatomegaly, + tournique test (apply tourniquet will see petechaie)

Laboratory findings — thrombocytopenia, leukopenia, elevations of AST

Dengue hemorrhagic fever — circulatory failure and shock
Diagnostic criteria: increased vascular permeability, marked thrombocytopenia, fever lasting 2 to 7 days, hemorrhagic tendency (+ tourniquet test or spontaneous bleeding)

shock syndrome (DSS) is used when shock is present along with criteria for denque hemorrhagic fever

DDx: influenza, enteroviral infection, measls, rubella, typhoid fever, leptospirosis

Generally a clinicl diagnosis but also can check serology for elevated IgM/IgG

Treatment is supportive

When a patient reports a recent travel history be sure to check the cdc webside.  It has information about what diseases are prevalent in specific countries.