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 an 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 of 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 the 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.