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Presentation OF DENGUE FEVER :


Presentation OF DENGUE FEVER :
Dengue fever has a duration of around 10 days(in most of the cases) . For ease of understanding we will divide these 10 days into three spans:
1 to 3 days… Common duration
4 to 6 days… Dangerous duration needs appropriate diagnosis
7 to 10 days… Resolution phase
COMMON DURATION (1ST DAY TO 3RD DAY):
By common duration we mean the first 3 days of dengue fever infection. I termed it as the common duration as it’s the time period during which you are not sure what you are dealing with and all the types of dengue fever may it be classic or hemorrhagic have same symptoms during this period and you can never diagnose the type of dengue. If we see a typical case scenario in which patient gets bitten from aedes egypti mosquito which had already bitten a dengue patient 2 days before. After 2 days of mosquito bite the patient may develop symptoms like
** High grade fever around 104 C
** Nausea
** Vomiting
** Head aches
** Muscle and back aches
** Retro orbital pains
** Sever weakness
The symptoms and presentations of patients vary a lot. You may get a patient who may present just with severe weakness without any fever or vomiting or aches and you will further see that he has dengue fever. So the symptoms vary and so the involvement of labs is very important to diagnose the dengue fever. All what we discussed is happening to the patient in first three days and all the patients of dengue either classic or hemorrhagic would present with same symptoms during first 3 days and you cannot tell the difference. Even the lab tests cannot tell us the difference and diagnosis but still its advisable for the patient to get his serial CBC done during these 3 days so that we may get reference values for comparison with deranged ones coming later in the disease.
DANGEROUS DURATION WITH APPROPRIATE DIAGNOSIS (4TH TO 6TH DAY)
Usually the fever of the patient goes during this duration. So its very important to advise the patient that as long as you have fever you are in the safe duration but as soon as your fever would subside must report to a doctor as that’s the time when we have to decide whether patient has dengue hemorrhagic fever or dengue classical fever. During this duration we can make accurate diagnosis of the type of dengue fever. For that purpose we will make use of some signs and some lab test which are as follows

Sings indicating that patient might be going in dengue hemorrhagic fever
1. Persistent vomiting
2. Right hypochondrium pain due to associated hepatitis
3. Decreased pulse pressure
If you see these three sings in any patient on his 4th day onwards of disease suspect dengue hemorrhagic fever in him and get lab tests done and manage accordingly
Tests during dangerous duration for diagnosis
§ CBC
§ Serum albumin
§ Serum cholesterol
§ Regular BP checkup
§ Live function tests
Now how will we diagnose the patient by help of these tests? Lets see. Its really easy. I would suggest that you go back to start of article and see the classification again. Now I would discuss all the classification in a way that you would know the way to diagnose the patient

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