Infectious Disease Compendium

Dengue

Diagnosis

Fever with myalgias/arthralgias (break bone fever), headache (retro-orbital) and rash.

When severe, patients can get hemorrhagic disease and sepsis. It is a capillary leak syndrome, so patients get hemoconcentration. Hepatitis is common as is cardiac involvement (PubMed).

Incubation is 3 to 14 days, but usually 4 to 7 days.

Epidemiologic Risks

Spread my mosquitoes from 35 degrees north and 35 degrees south. For now. Expect the range to increase as the world heats up. It has been found in the Florida keys.

Whites have increased risk of severe disease. That's what they get for evolving in a non-tropical part of the world.

Microbiology

A flavivirus, there are 4 serotypes. Infection with one serotype increases the risk for DHF with subsequent infections with other serotypes.

Diagnose with PCR, viral antigen detection (such as NS1) or serology.

Empiric Therapy

None, supportive. Steroids don't help (PubMed). Lots of fluids may increase chance of severe disease: "patients who received IV fluids had a 3.6-fold greater risk of developing severe dengue"(Poster), although I am skeptical.

Pearls

Is it dengue? Yellow Fever? Chikungunya? Something else? Always the question.

Rants

Expect the range of dengue, and other tropical diseases, to go North with global warming.

Last Update: 06/19/18.