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.
