Infectious Disease Compendium

Dengue

Diagnosis

Review

A disease of world wide tropical distribution. 4 types, cleverly called 1,2,3,4. The virus is moving north with global warming and is found in Florida Keys and Texas. It was wandering back and forth over the border from Arizona and Mexico.

Can be a mild illness to dengue hemorrhagic fever or severe dengue: plasma leak withshock, ARDS, or both; severe bleeding and severe organ impairment.

Epidemiologic Risks

Mosquito bites. It is curious that severe disease is more likely to occur with sequential infections by different types.

It is endemic in a park in Tokyo, Japan as of 2014 (PubMed). It is just matter of time before it is endemic the US South.

Microbiology

A flavivirus

Empiric Therapy

Supportive. Maybe prochlorperazine (PubMed).

Pearls

There is a vaccine coming that reduces symptomatic disease and the trials have also shown that immunity from natural infection is not lifelong (Pubmed).

And in Central America it may actually be Punta Toro (Spanish for kick a bull on 4th down I think) virus as a dengue mimic (PubMed).

Rants