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Dengue hemorrhagic fever - Symptom

Alternative Names

Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever

Symptoms:

Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. These symptoms are followed by a shock -like state.

Bleeding may appear as tiny spots of blood on the skin (petechiae) and larger patches of blood under the skin (ecchymoses). Minor injuries may cause bleeding.

Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.

Early symptoms include:

  • Decreased appetite
  • Fever
  • Headache
  • Joint aches
  • Malaise
  • Muscle aches
  • Vomiting

Acute phase symptoms include:

  • Restlessness followed by:
    • Ecchymosis
    • Generalized rash
    • Petechiae
    • Worsening of earlier symptoms
  • Shock-like state
    • Cold, clammy extremities
    • Sweatiness (diaphoretic)

Signs and tests:

A physical examination may reveal:

Tests may include:

  • Arterial blood gases
  • Coagulation studies
  • Electrolytes
  • Hematocrit
  • Liver enzymes
  • Platelet count
  • Serologic studies (demonstrate antibodies to Dengue viruses)
  • Serum studies from samples taken during acute illness and convalescence (increase in titer to Dengue antigen)
  • Tourniquet test (causes petechiae to form below the tourniquet)
  • X-ray of the chest (may demonstrate pleural effusion)
  • Reviewed last on: 12/7/2010
  • Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Vaughn DW, Barrett A, Solomon T. Flaviviruses (Yellow Fever, Dengue, Dengue Hemorrhagic Fever, Japanese Encephalitis, West Nile Encephalitis, St. Louis Encephalitis, Tick-Borne Encephalitis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 153.

Haile-Mariam T, Polis MA. Viral illnesses. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 128.

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