Dengue fever
| Headline | |
|---|---|
| Etiology | mosquito-borne flavivirus (enveloped, single-stranded positive-sense RNA virus). Hard to distinguish between arboviruses! |
| Epidemiology | Spread by Aedes mosquitoes (day-biting) - Asia 70% of disease burden - Children more likely to develop dengue haemorrhagic fever Risk factors for severe dengue - pregnancy - age <1 year or age >65 - hypertension, CKD, heart failure, obesity, asthma |
| Clinical presentation | retro-orbital pain, headache, rash (3-5 days before fever), fever (day 5-7, lasts 2-3 days), arthralgia papular → petechial → desquamating rash warning signs: vomiting >3x in 1h, mucosal bleeding, third spacing (e.g. gallbladder oedema), rapid ↓ in platelets, hepatomegaly, lethargy, restlessness severe dengue: shock, bleeding, respiratory distress |
| Pathogenesis | |
| Diagnostic investigations | 3x blood cultures are diagnostic! ➥ Bloods: ↑ ALT; FBC normal Complications: Dengue haemorrhagic shock/”severe dengue”– if previous episode |
| Management | Supportive, most are self-resolving 3-7d ➥ Warn pts – can be followed by 6-8/52 severe fatigue ➥ IV fluids ➥ generally avoid empirical NSAIDs or abx ➥ Prevention: vector control, preventing bites. Globally there are vaccinations but idk how available in the UK |