From the Guidelines
Symptoms of dengue fever typically include high fever, severe headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen glands, and rash, as described in the most recent guidelines 1. The illness usually begins 4-10 days after infection and lasts for 2-7 days. Most people recover completely, but some may develop severe dengue, characterized by severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums or nose, fatigue, restlessness, blood in vomit or stool, and excessive thirst. These severe symptoms require immediate medical attention as they can be life-threatening. Dengue is caused by a virus transmitted through the bite of infected Aedes mosquitoes, primarily Aedes aegypti. There is no specific medication for dengue, so treatment focuses on relieving symptoms with rest, fluids, and acetaminophen (paracetamol) for fever and pain. Avoid aspirin and NSAIDs like ibuprofen as they can increase bleeding risk. If you suspect dengue, especially in endemic areas after mosquito exposure, seek medical care promptly for proper diagnosis and monitoring, as recommended by the Centers for Disease Control and Prevention 1. The diagnosis of dengue fever can be confirmed by nucleic acid amplification tests (NAATs) and immunoglobulin M (IgM) antibody testing, as outlined in the guidelines 1. It is essential to consider the epidemiology of viruses known to be circulating at the location of exposure and clinical findings when interpreting the results of serologic diagnostic testing 1. In areas where both dengue and Zika viruses are circulating, it is crucial to perform diagnostic testing for both viruses, as the symptoms and transmission cycles are similar 1. The interpretation of results should be based on the most recent guidelines and should take into account the specific timing of infection, which cannot be determined by IgM antibody testing alone 1. Therefore, prompt medical attention and proper diagnosis are crucial for patients with suspected dengue fever, especially in endemic areas.
From the Research
Symptoms of Dengue Fever
- Acute-onset high fever 2
- Muscle and joint pain 2
- Myalgia 2
- A rash on the skin 2
- Hemorrhagic episodes 2
- Circulatory shock 2
- Thrombocytopenia and hemoconcentration are distinguishing features between DHF/DSS and dengue fever (DF) 3
- Significant bleed and mild thrombocytopenia but no hemoconcentration in some patients with dengue fever 3
Laboratory Findings
- Rising hematocrit 3
- Thrombocytopenia 3
- Transformed lymphocytes on peripheral smear 3
- Increased transaminases 3
- Hyponatremia 3
- Transient increase in blood urea nitrogen and creatinine 3
- Lab evidence of dissemination intravascular coagulation in severe disease 3
Diagnostic Imaging
- X-ray film of the chest may show pleural-effusion 3
- Ultrasonogram of abdomen may detect thickened gall bladder wall with hepatomegaly and ascitis 3
- Abnormality in electrocardiogram and echocardiogram in some patients 3
Clinical Manifestations
- Dengue virus infection may remain asymptomatic or manifest as nonspecific viral infection to life threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS) 3
- Clinical signs and symptoms of dengue infection range from mild dengue fever (DF) to potentially lethal conditions like DHF or dengue shock syndrome (DSS) 2, 4, 5