eMedicine Specialties > Emergency Medicine > Infectious Diseases
Dengue Fever: Differential Diagnoses & Workup
Updated: Nov 16, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
| Hepatitis | Tick-Borne Diseases, Rocky Mountain Spotted
Fever |
| Malaria | Yellow Fever |
| Meningitis | |
| Pediatrics, Bacteremia and Sepsis | |
| Pediatrics, Meningitis and Encephalitis |
Other Problems to Be Considered
Leptospirosis
Rickettsioses
River viruses
Scrub typhus
Typhoid
Viral infections (eg, influenza, chikungunya, Mayaro fever, Rift Valley fever, West Nile, Sindbis, and Ross River)
Workup
Laboratory Studies
- Isolation of virus in serum and detection of immunoglobulins (IgM and IgG) by enzyme-linked immunosorbent assay (ELISA) antibody capture, monoclonal antibody, or hemagglutination
- Complete blood count
- Hemoconcentration (hematocrit increased 20%)
- Thrombocytopenia (platelet count <100 x 109/L)
- Leukopenia
- Chemistry panel
- Electrolyte imbalances
- Acidemia
- Elevated BUN
- Liver function tests
- Elevated transaminases
- Hypoproteinemia
- Guaiac test for occult blood in stool
- DIC panel, as indicated
Imaging Studies
- Chest radiography
- Bronchopneumonia
- Pleural effusion
- Head CT scan without contrast
- For altered level of consciousness
- Intracranial bleeding
- Cerebral edema
Other Tests
- Electrocardiography
- Nonspecific changes may be effects of fever, electrolyte disturbances, tachycardia, or medications.
- Usefulness of these changes as a marker of cardiac involvement is unclear.
More on Dengue Fever |
| Overview: Dengue Fever |
Differential Diagnoses & Workup: Dengue Fever |
| Treatment & Medication: Dengue Fever |
| Follow-up: Dengue Fever |
| Multimedia: Dengue Fever |
| References |
| Further Reading |
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References
Malavige GN, Fernando S, Fernando DJ, et al. Dengue viral infections. Postgrad Med J. Oct 2004;80(948):588-601. [Medline].
Stephenson JR. Understanding dengue pathogenesis: implications for vaccine design. Bull World Health Organ. Apr 2005;83(4):308-14. [Medline].
Gurtler RE, Garelli FM, Coto HD. Effects of a Five-Year Citywide Intervention Program To Control Aedes aegypti and Prevent Dengue Outbreaks in Northern Argentina. PLoS Negl Trop Dis. 2009;3(4):e427. [Medline].
Monath TP. Dengue and yellow fever--challenges for the development and use of vaccines. N Engl J Med. Nov 29 2007;357(22):2222-5. [Medline].
Lang J. Recent progress on sanofi pasteur's dengue vaccine candidate. J Clin Virol. Oct 2009;46 Suppl 2:S20-4. [Medline].
Morens DM. Antibody-dependent enhancement of infection and the pathogenesis of viral disease. Clin Infect Dis. Sep 1994;19(3):500-12. [Medline].
Guzman MG, Kouri G. Dengue and dengue hemorrhagic fever in the Americas: lessons and challenges. J Clin Virol. May 2003;27(1):1-13. [Medline].
Guzman MG, Kouri G. Dengue: an update. Lancet Infect Dis. Jan 2002;2(1):33-42. [Medline].
Halstead SB. Pathogenesis of dengue: challenges to molecular biology. Science. Jan 29 1988;239(4839):476-81. [Medline].
Hoeprich PD, Jordan MC, Ronald AR, eds; Halstead SB. Infectious Diseases: A Treatise of Infectious Processes. 1994:919-923.
Kao CL, King CC, Chao DY, et al. Laboratory diagnosis of dengue virus infection: current and future perspectives in clinical diagnosis and public health. J Microbiol Immunol Infect. Feb 2005;38(1):5-16. [Medline].
Kuno G. Review of the factors modulating dengue transmission. Epidemiol Rev. 1995;(2):321-35. [Medline].
Mandell GL, Douglas RG Jr, Bennett JE, eds; Monath TP. Principles and Practice of Infectious Disease. 3rd ed. Churchill Livingstone Inc; 1990:1248-1251.
Monath TP. Yellow fever and dengue: The interactions of virus, vector, and host in the re-emergence of epidemic disease. Semin Virol. 1994;5:133-145.
Ray CG, Ryan KJ, ed. Sherris Medical Microbiology: An Introduction to Infectious Diseases. McGraw-Hill Professional Publishing; 1994:525-535.
Tassniyom S, Vasanawathana S, Chirawatkul A, Rojanasuphot S. Failure of high-dose methylprednisolone in established dengue shock syndrome: a placebo-controlled, double-blind study. Pediatrics. Jul 1993;92(1):111-5. [Medline].
World Health Organization. Dengue Haemorrhagic Fever: Diagnosis, Treatment and Control. World Health Org; 1986:1-2.
Further Reading
Clinical guidelines
Epidemic/epizootic West Nile virus in the United States: guidelines for surveillance, prevention, and control.
Centers for Disease Control and Prevention - Federal Government Agency [U.S.]
Department of Health and Human Services (U.S.) - Federal Government Agency [U.S.]
Division of Vector-Borne Infectious Diseases (Fort Collins, Colorado) - Federal Government Agency [U.S.]
National Center for Infectious Diseases - Federal Government Agency [U.S.]
Public Health Service (U.S.) - Federal Government Agency [U.S.]. 2001 Apr (revised 2003). 75 pages. NGC:003165
The practice of travel medicine: guidelines by the Infectious Diseases Society of America.
Infectious Diseases Society of America - Medical Specialty Society. 2006. 96 pages. NGC:005086
Clinical trials
Study of Sanofi Pasteur's CYD Dengue Vaccine in Healthy Subjects in Singapore
Study of ChimeriVax Tetravalent Dengue Vaccine in Healthy Subjects
Efficacy and Safety of Dengue Vaccine in Healthy Children
Safety of and Immune Response to Two Different Dengue Virus Vaccines in Individuals Previously Immunized Against Dengue Virus
A Study of Two Doses of WRAIR Dengue Vaccine Administered Six Months Apart to Healthy Adults and Children
Keywords
breakbone fever, ki denga pepo, mosquito-transmitted viral disease, febrile syndrome, bleeding diathesis, disseminated intravascular coagulation, DIC, dengue hemorrhagic fever, DHF, dengue shock syndrome, DSS, dengue viral infections, dengue fever


Differential Diagnoses & Workup: Dengue Fever