Learn More Dengue Clinical Case Management E-learning

Differentiating Dengue from Other Acute Febrile

Illnesses
Event Leptospirosis Malaria Typhoid Fever
Leptospira spp. Plasmodium spp. • Salmonella serotype Typhi
Disease and
Agent • Salmonella Paratyphi A,
B, C
Contact with animal Mosquito bite Consumed water or food
(usually rat, dog, cattle, contaminated with human
Transmission pig) urine, feces from an acutely ill or
contaminated water or convalescent patient or a
soil silent chronic carrier
2–30 days As short as 7 days but 7–42 days
Incubation commonly 2–4 weeks

Jaundice, conjunctival Recurrent fevers can Red spots (trunk). Can be

Differentiating suffusion, acute renal occur difficult to see, particularly in
Features failure persons of color

• Renal failure • Cerebral malaria • Intestinal perforation

• Pulmonary bleeding • ARDS • Shock
Complications • Hepatic dysfunction • Renal failure • Neurologic disease
• Meningitis • Hemolytic anemia

• Serology tests (IgM, • Tick and thin blood • Culture blood, BM, and
paired MAT) smear stool

Diagnosis • Culture blood, CSF, • Rapid dx test or PCR1 • Serology test (paired)
and urine
• Rapid test is useful for
outbreak confirmation

Penicillin G IV for severe Drug choice based on Drug choice based on

cases where acquired, disease antimicrobial resistance
severity, parasite species, patterns
and density
Treatment (adults
and children of all
ages) Doxycycline po Doxycycline po Empiric treatment:
Ciprofloxacin po or
Ceftriaxone IV or IM

1
Malaria PCR and rapid diagnostic tests also available. CDC telediagnosis service called DPDx available; send photos of
smears to: dpdx@cdc.gov

Centers for Disease Control and Prevention

National Center for Emerging and Zoonotic Infectious Diseases