Dengue hemorrhagic fever

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Mosquito, adult feeding on the skin

Dengue hemorrhagic fever

Alternative Names:

Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever
Symptoms:

Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. These symptoms are followed by a shock-like state.

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Bleeding may appear as pinpoint spots of blood on the skin (petechiae) and larger patches of blood under the skin (ecchymoses). Bleeding may occur from minor injuries.

Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.

Early symptoms include the following:

Fever
Headache
Muscle aches
Joint aches
Malaise
Decreased appetite
Vomiting

Acute phase symptoms include the following:

Shock-like state
- Sweaty (diaphoretic)
- Cold, clammy extremities
Restlessness followed by:
- Worsening of earlier symptoms
- Petechiae
- Ecchymosis
- Generalized rash

Signs and tests:

Physical examination may reveal the following:

Low blood pressure
A weak, rapid pulse
Rash
Red eyes
Red throat
Swollen glands
Enlarged liver (hepatomegaly)

Tests may include the following:

Hematocrit
Platelet count
Electrolytes
Coagulation studies
Liver enzymes
Blood gases
Tourniquet test (causes petechiae below the tourniquet)
X-ray of the chest (may demonstrate pleural effusion)
Serologic studies (demonstrate antibodies to Dengue viruses)
Serum studies from samples taken during acute illness and convalescence (increase in titer to Dengue antigen)