Infectious Disease Protocol Medically Reviewed by Board

Comprehensive Clinical Overview: Dengue Virus Infection

Dengue is a mosquito-borne viral infection transmitted principally by female Aedes aegypti mosquitoes. Early recognition of clinical symptoms, daily hematocrit/platelet monitoring, and aggressive fluid hydration are critical to prevent Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS).

Dengue Diagnostic & Triage Flowchart

1
FEBPHASE (Days 1–3)

High fever (104°F), retro-orbital pain, severe myalgia ("breakbone fever"). Test NS1 Antigen.

2
CRITICAL PHASE (Days 4–6)

Fever defervescence. Monitor CBC daily for rising hematocrit & dropping platelet count (<100,000/μL).

3
WARNING FLAGS

Abdominal pain, persistent vomiting, mucosal bleeding, lethargy. Immediate hospital admission required.

4
RECOVERY (Days 7+)

Plasma reabsorption, appetite return, stabilization of blood counts.

1. Key Symptoms & Clinical Presentation

Dengue symptoms typically manifest 4 to 10 days post-infection through an infected mosquito bite. Symptoms include:

  • Sudden High Fever: Temperature spiking up to 40°C (104°F).
  • Severe Retro-Orbital Eye Pain: Pain behind the eyeballs exacerbated by eye movement.
  • Severe Myalgia & Arthralgia: Severe muscle and joint pains giving rise to the term "breakbone fever".
  • Maculopapular Rash: Transient rash appearing 2 to 5 days after fever onset.
  • Gastrointestinal Distress: Mild nausea, loss of appetite, and vomiting.

2. Laboratory Diagnostic Testing & LIMS Tracking

Diagnostic Test Optimal Testing Window Clinical Significance
Dengue NS1 Antigen Test Days 1 to 5 of Fever Detects viral non-structural protein 1 during early acute infection stage.
Dengue IgM / IgG Antibodies Day 5 onwards IgM indicates active primary infection; IgG indicates secondary past infection risk.
Complete Blood Count (CBC) Daily during fever Monitors hematocrit levels (hemoconcentration) and platelet counts.