Question

A 40-year-old male with a history of intravenous drug use comes to the emergency room because of a rash and fever. In addition, the patient is complaining of a several-day history of malaise, fatigue, fever, headache, and a sore throat.

Physical examination reveals a moderately ill-appearing male with a temperature of 101.6°F. He has a blanching erythematous, macular-papular rash evident over the trunk, back, and upper and lower extremities. In addition, his throat shows enlarged tonsils and broad-based ulcerations on the buccal mucosa.

He has a history of an episode of endocarditis 2 years ago. At the time, an HIV serology was performed. It was negative.

Laboratory Data:

A complete blood count and liver function test are ordered. The results of these tests show that the patient is anemic (Hct 38%). He also has a severely decreased total leukocyte count. Some of his liver function tests are abnormal.

Questions:

1. What is the likely diagnosis of this patient’s condition?

2. What is the natural history of this disease?

3. What immunologic laboratory tests might be of value in stabling a diagnosis for this patient?

Answer 1

1.

Patient's diagnosis might be Dengue hemorrhagic Fever.

Because all the symptoms expressed by the patient are the features of Dengue. Those include

• Rash on trunk
• Fever
• Malaise
• Fatigue
• Head ache
• Sore throat
• Severely decreased leukocyte count.

2.

Dengue is a vector borne disease caused by the bite of aedes aegypti.

Rarely it spreads through needle sticks.

Symptoms of Dengue are as above said.

Diagnosed by the laboratory tests for dengue virus and WBC count.

Treatment mainly focuses on supportive treatment.

Mainly we have to combat decreased wbc count.

3.

in the Dengue fever wbc are mainly affected, which are the pillars of immune system. So that immunological lab tests are valuable in diagnosing dengue.