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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Rev. chil. pediatr. vol.88 no.4 Santiago  2017

http://dx.doi.org/10.4067/S0370-41062017000400019 

Carta al Editor

 

Afebrile dengue

Viroj Wiwanitkit1

1Visiitng professor, Hainan Medical University, China; visiting professor, Faculty of Medicine, University of Nis, Serbia; honorary professor, Dr. DY Patil University, India; adjunct professor, Joseph Ayobabalola University, Nigeria.

Dear editor, the recent publication on dengue by Méndez-Domínguez et al. is very interesting1. Méndez-Domínguez et al. concluded that “dengue fever in young infant infections may be afebrile, so it is important to suspect them appropriately in the presence of a generalised rash, tachycardia, and hypotension, in order to avoid the deadly consequences of dengue shock1.” I would like to share experience and discuss on the afebrile dengue. In fact, dengue can present without fever, especially for the case that receive antipyretic drug2-3. In Thailand, where dengue prevalence is extremely high, “up to 20% had afebrile presentation3. Sometimes, the case has fulfill dengue triad (hemoconcentration, atypical lymphocytosis and thrombocytopenia) without fever1,3 and it is difficult for diagnosis. Some patients might present only with complaint of malaise and myalgia4. In tropical countries, dengue should be included in differential diagnosis of any patient with acute illness regardless of fever.

References

1. Méndez-Domínguez N, Achach-Medina K, Morales-Gual YM, Gómez-Carro S. Dengue with unusual clinical features in an infant: Case report. Rev Chil Pediatr. 2017 Apr;88(2):275-9.         [ Links ]

2. Wiwanitkit V. Dengue fever: diagnosis and treatment. Expert Rev Anti Infect Ther. 2010 Jul;8(7):841-5.         [ Links ]

3. Wiwanitkit S, Wiwanitkit V. Afebrile dengue: An easily forgotten manifestation. Ann Trop Med Public Health. 2013;6:686.         [ Links ]

4. Yasri S, Wiwanitkit V. Afebrile dengue myositis. Ann Trop Med Public Health. 2016;9:360.         [ Links ]

___________________
Correspondencia a: wviroj@yahoo.com

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