Clinical review on Dengue fever in the BMJ
Useful comprehensive clinical review on Dengue fever in the BMJ– at a time when cases are at a high in some parts of the country
This clinical review has been developed for The BMJ in collaboration with BMJ Best Practice, based on a regularly updated web/mobile topic that supports evidence based decision making at the point of care.
Dengue fever is a globally important arboviral infection transmitted by mosquitoes of the Aedes genus (primarily Aedes aegypti, but also A albopictus), an insect found in tropical and subtropical regions.
Dengue fever should be suspected in any patients residing in countries where the infection is endemic and in those who travelled in such areas within the past two weeks.
The onset of symptoms after the incubation period is usually abrupt. Fever is characteristic of infection and is often abrupt in onset with high spikes of 39.4-40.5°C. It may also be biphasic and have a remittent pattern or be low grade, and generally lasts for five to seven days. In young children fever may cause febrile seizures or delirium. Patients with rapid defervescence may be about to enter the critical phase of infection.
Aches and pains, particularly backache, arthralgia, myalgia, and bone pain, are common. Headache is also typical of infection and is generally constant and towards the front of the head. It usually improves within a few days. Severe retro-orbital pain n eye movement or with a little pressure applied to the eyeball is also usual.