Case reportThe exanthem of dengue fever: Clinical features of two US tourists traveling abroad
Section snippets
Case 1
A previously healthy 32-year-old woman from San Francisco, Calif, developed headache, fever, extreme fatigue, and a flushing macular erythema over the chest 2 days after returning from a vacation in Central Mexico. Three days later, she developed a generalized morbilliform eruption studded with pinpoint petechiae and islands of sparing.
Initial laboratory evaluations indicated a white blood cell count of 1.5 × 109/L (normal 3.4-10 × 109/L), a hematocrit of 48.9% (normal 36%-46%), a platelet
Case 2
A previously healthy 21-year-old female college student presented to a hospital in New York City with a generalized rash 2 days after returning to the United States after spending 1 month in Thailand. Two days before returning to the United States, she developed the sudden onset of high fever, myalgias, and severe fatigue. On examination, she had a diffuse morbilliform eruption with petechiae and islands of sparing (Fig 1). When she first developed symptoms in Thailand, she thought she had
Discussion
Dengue virus, of the family Flaviviridae, is a single-stranded RNA virus transmitted by the mosquitoes Aedes aegypti and Aedes albopictus. There are 4 serotypes of the dengue virus (DEN 1-4). Infection with one strain provides lifelong immunity to that strain, but only a few months of immunity to other strains.
Infection with the dengue virus can cause a spectrum of 3 clinical syndromes: classic dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. World Health Organization criteria
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Conflicts of interest: None declared.