What is atypical dengue presentation? Doctor shares diagnosis, treatment and prevention tips

Unconventional presentations of dengue are increasingly frequent, particularly from regions with frequent outbreaks. Both healthcare workers and the general public need to be alerted to the different forms of presentation to enable prompt diagnosis and effective treatment.

New Delhi:

Dengue fever, a viral infection transmitted by mosquitoes due to the dengue virus, is famously known for its typical presentation—high-grade fever, severe headache, pain in muscles and joints, and rash. Yet, over the last few years, physicians have increasingly come across atypical dengue presentations that are different from the classical clinical presentation, posing difficulties in diagnosis and management.

What is atypical dengue?

As per Dr Tushar Tayal, Consultant, Internal Medicine, CK Birla Hospital, Gurugram, atypical dengue or expanded dengue syndrome is the uncommon presentation of the disease that can involve other organs besides the usual haematologic and vascular systems. The presentations include the liver (hepatitis), brain (encephalitis), heart (myocarditis), kidneys (acute kidney injury), and gastrointestinal system (severe abdominal pain, vomiting, or bleeding). Low or absent fever and false-negative initial examinations can also occur in patients.

Diagnosis

Diagnosis of atypical dengue needs a high degree of suspicion, particularly in outbreaks or in endemic areas. Laboratory investigations such as NS1 antigen, dengue IgM/IgG antibodies, and RT-PCR are essential for confirmation. Clinicians also need to check organ function with investigations such as liver enzymes, renal function tests, and imaging studies if complications are suspected.

Treatment

No antiviral therapy is specific to dengue. Supportive care according to the involved organ system is what management of atypical presentations involves. Intravenous fluids, antipyretics (without NSAIDs), blood component replacement, and organ support (such as dialysis or ventilator support) can be required. Multidisciplinary and early recognition are the basis for preventing complications and mortality.

Prevention

Prevention methods are the same as for traditional dengue. They are eradicating breeding places for mosquitoes, applying mosquito repellents, wearing protective clothing and ensuring window screens or bed nets. Community knowledge and early medical consultation when symptoms occur, even if they are unusual, are imperative.

Disclaimer: (Tips and suggestions mentioned in the article are for general information only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.)

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