Pediatric emergency medicine trisk 2389 2389

Type
Asymptomatic

Clinical presentation

Approximately 50% of infected individuals remain
asymptomatic
Undifferentiated
Relatively benign febrile illness
fevers
Typically in young children experiencing their first
infection
Many go undiagnosed because of similarities with other
febrile illnesses
Dengue fever
Fever and develop two or more of the following:
without warning • Nausea or vomiting
signs
• Myalgias and/or arthralgias
• Diffuse erythematous maculopapular rash
• Leukopenia
• Positive tourniquet test (inflation of a blood pressure cuff
for 5 min results in >10–20 petechiae per square inch; a
measure of capillary fragility)
Dengue with
Symptoms of dengue without warning signs with any of
warning signs
the following additional symptoms:
• Abdominal pain or tenderness
• Persistent emesis
• Fluid overload (ascites, pleural effusion)

• Mucosal bleeding
• Lethargy
• Hepatomegaly (liver edge appreciable 2 cm below costal
margin)
• Increased hemoglobin (from hemoconcentration) and
thrombocytopenia
Severe dengue
Symptoms of dengue with warning signs with any of the
fever or dengue
following:
shock syndrome • Severe plasma leakage with resultant:
• Shock
• Fluid accumulation resulting in respiratory distress or
failure
• Severe bleeding