Dengue virus

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Dengue virus

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USMLE® Step 1 style questions USMLE

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A 51-year-old woman comes to the emergency department for evaluation of myalgias, fever, and a petechial rash for the past two days. She recently returned from a ten-day trip to West Africa. She states she had similar symptoms three years ago, resolved with supportive care at home. The patient's temperature is 39.4 °C (102.9 °F). Pulse is 100/min, respiratory rate 17/min, and blood pressure 90/50 mmHg. She develops petechial lesions over the distal right arm after a blood pressure measurement is obtained using a sphygmomanometer. The remainder of the physical examination is within normal limits. Initial laboratory workup is shown below. Which of the following is the most likely diagnosis?  

 Laboratory value 
 Serum chemistries  Result 
 Hemoglobin  9.8 g/dL 
 Hematocrit  30 % 
 Leukocyte count  2000 /mm3 
 Platelet count  50,000 /mm3 
 AST  170 U/L 
 ALT  200 U/L 
 Serum creatinine  1.4 mg/dL 

External References

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Dengue p. 164

Summary

Dengue virus is a single-stranded RNA virus known to cause dengue fever. Dengue virus is transmitted by a mosquito, especially a species known as Aedes aegypti. Symptoms of dengue fever include fever, headache, muscle pain, and rash. In some cases, the infection can progress to Dengue Hemorrhagic Fever (DHF), a life-threatening condition. There is no specific treatment for Dengue Fever or DHF, and patients are typically given supportive care. Prevention of the disease is through vaccination and avoidance of mosquitoes.