Unusual presentation of dengue fever

ABSTRACT

Dengue infection can present with varying clinical manifestations, which may not conform to the defi nitions of the World Health Organization [WHO] classifi cation. Flushing, puffi ness and cyanosis are some of the features, which are not included in the WHO criteria. Bleeding and thrombocytopenia are conspicuously absent in some children with "true" dengue hemorrhagic fever. Revised classifi cation based on dengue control study, in comparison with WHO classifi cation is defi nitely exclusive at detecting severe dengue infection. In fact fl ushing, puffi ness and cyanosis are not included in the past or recent WHO classifi cation criteria of dengue fever. It is practically feasible and facilitates realtime case management. All the classifi cations are only the guidelines and a good clinical acumen is an absolute necessity in diagnosing the criticality of the patient and prioritizing them for specifi c treatment