Brief Answer:
Dengue fever

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Dengue fever is usually mild. The typical patient experiences the sudden onset of fever, frontal headache, retroorbital pain, and back pain along with severe myalgias. Often a transient macular rash appears on the
first day. The illness may last a week, with additional symptoms and clinical signs usually including anorexia, nausea or vomiting.Laboratory findings include mild-to-moderate thrombocytopenia and leukopenia, often with a moderate elevation of hepatic aminotransferase levels. This phase lasts for 3 to 7 days, after which most patients recover without complications.

Dengue hemorrhagic fever is severe dengue - identified by the detection of bleeding tendencies (tourniquet test, petechiae) or overt bleeding in the absence of underlying causes, such as preexisting gastrointestinal lesions. Shock may result from increased vascular permeability.

In milder cases of severe dengue, restlessness, lethargy, thrombocytopenia (<100,000/μL), and hemoconcentration are detected 2–5 days after the onset of typical dengue, usually at the time of defervescence. The maculopapular rash that often develops in dengue may also appear in severe dengue.

In more severe cases, XXXXXXX shock is apparent, with low pulse pressure, cyanosis, hepatomegaly, pleural effusions, and ascites; in some patients, severe ecchymoses and gastrointestinal bleeding develop. The period of shock lasts only 1 or 2 days.However, most patients with severe dengue respond well to supportive therapy(close monitoring, oxygen administration, and infusion of crystalloid or—in severe cases—colloid).

Your friend has secondary dengue (as he or she had dengue 4 years back).

Patients with secondary infections mount rapid anamnestic antibody responses in which dengue virus–reactive IgG may predominate over IgM. Apart from the virus-expressed soluble nonstructural protein 1 (NS1) ,what is the dengue IgM & IgG report?
Currently, no effective antiviral agents to treat dengue infection are available, and treatment remains supportive, with particular emphasis on careful fluid management.



Regards

Dr. T.K. Biswas M.D. XXXXXXX

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