Infectious Disease Compendium

Dengue

Diagnosis

Fever with myalgias (break bone fever) 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 involvemnet (PubMed).

Epidemiologic Risks

Spread my mosquitoes from 35 degrees north and 35 degrees south. For now (2009). Expect the range to increase as the world heats up. It has been found in the Florida keys.

Microbiology

A flavivirus, there are 4 serotypes. Whites have increased risk of severe disease. That's what they get for evolving in a non tropical part of the world.

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.

A quadravalent vaccine is, as of 2015, close.

Pearls

Rants

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

ICD9 Codes (Soon to be supplanted by ICD10)

Dengue (fever) 061; virus hemorrhagic fever 065.4.