Clinical Spectrum and Unusual Manifestations of Dengue Fever

Dengue viral infection has become a significant public health concern with increased recognition of atypical manifestations apart from the classical clinical features. Appropriate, timely diagnosis and risk stratification for severe disease are crucial in the optimal management of this illness. The study outlines the evolving clinical spectrum of dengue with special emphasis on unusual manifestations.

A prospective hospital based study was conducted over a period of two years (June-2013 to May-2014). Data of 186 IgM dengue antibody-confirmed hospitalised cases was collected, compiled and analysed. Atypical manifestations in dengue fever were noted and analyzed.

The dengue infection was affecting mostly the younger age group with male preponderance. Most common symptoms apart from fever and headache were gastrointestinal symptoms like abdominal pain, vomiting and diarrhoea. Liver injury was almost universally present in the form of transaminitis. Atypical features were seen in 38.17% cases. Platelet count did not correlate exactly with severity of bleeding. Overall recovery rate was good. 4 (2.15%) patients succumbed to multiorgan failure and shock.

Dengue illness may have a non-specific and varied presentation, thus mandating its screening in febrile illness especially during the post-monsoon period. An understanding of the course of disease progression, recognition of the warning signs during the different phases of the disease will enable primary care physicians to manage dengue fever in an appropriate and timely manner to reduce morbidity and mortality.