USMLE

Dengue Virus

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Viruses - RNA Viruses
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Key Points

  • Dengue virus
    • Also known as Dengue Hemorrhagic Fever (DHF)
    • Member of Flavivirus family
    • Characteristics
      • 4 different serotypes; can cause secondary infection with different serotype
        • Secondary infection is usually more severe, perhaps due to increased immune response
    • Transmission
      • Transmitted by Aedes mosquito
    • Presentation
      • Primary infection is usually mild or asymptomatic
      • Secondary infection with a different serotype causes severe illness
        • High fever, headache, nausea/vomiting
        • Bleeding
          • Increased capillary permeability
          • Epistaxis
          • Petechia/purpura (may lead to blanching rash)
        • Hepatitis
          • Elevated liver enzymes
        • Severe muscle and bone pain (“break bone fever”)
        • Retroorbital pain
        • Shock, respiratory/circulatory failure
    • Diagnosis
      • Tourniquet test
        • Petechiae observed after a tourniquet (e.g. inflated blood pressure cuff) is placed for 5 minutes