title: Imported Dengue fever presenting with febrile diarrhoea: report of two cases.
abstract: Dengue fever is a significant health problem in most tropical regions and increasingly observed among travelers returning from tropical countries. Clinical presentation might not be typical in patients from non-endemic areas. We report 2 patients returning from South-East Asia with proven Dengue-virus infection initially presenting with "febrile diarrhea" followed by hemorrhagic skin lesions during hospitalization. Blood and stool examination remained negative for bacteria, parasites and plasmodia. Dengue fever was suspected early, mainly due to the typical course of the complete blood cell count with thrombocytopenia (19 x 10(9)/L and 86 x 10(9)/L) and leucopenia (3 x 10(9)/L and 1.8 x 10(9)/L). Both patients had a benign clinical course, which still required intensive care monitoring. Platelet inhibitors and NSAIDs should be stopped when Dengue infection (Dengue fever and Dengue hemorrhagic fever) is suspected in order to minimalize the risk of bleeding. Although presentation of the disease might not always be typical, Dengue infection has to be considered early in the course of disease by taking an in-depth history and profound physical examination.
authors.affiliation: Department of Neurology, University of Innsbruck, Innsbruck, Austria. raimund_helbok@yahoo.com
authors.forename: Raimund
authors.initials: R
authors.lastname: Helbok
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dent
authors.forename: Klaus
authors.initials: K
authors.lastname: Gattringer
authors.forename: Martha
authors.initials: M
authors.lastname: Innerebner
authors.forename: Erich
authors.initials: E
authors.lastname: Schmutzhard
mesh_terms: D000328:Adult; D000368:Aged; D001210:Asia, Southeastern; D001772:Blood Cell Count; D003422:Critical Care; D003715:Dengue / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D003716:Dengue Virus / Q000302:isolation & purification; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D010808:Physical Examination; D019595:Severe Dengue / Q000175:diagnosis; D014195:Travel