Dengue fever

The clinical features of DF frequently depend on the age of the patient. Infants and young children may have an
undifferentiated febrile disease, often with a maculopapular rash. Older children and adults may have either a mild
febrile syndrome or the classic incapacitating disease with high fever of abrupt onset, sometimes with 2 peaks
(saddle-backed), severe headache, pain behind the eyes, muscle and bone or joint pains, nausea and vomiting, and
rash. Skin haemorrhages (petechiae) are not uncommon. Leukopenia is usually seen and thrombocytopenia may be
observed. Recovery may be associated with pro-longed fatigue and depression, especially in adults.
In some epidemics, DF may be accompanied by bleeding complications, such as epistaxis, gingival bleeding,
gastrointestinal bleeding, haematuria, and