title: Severe, persisting, steroid-responsive Dengue myositis.
abstract: OBJECTIVE
  Short-term, general muscle affection is frequent in Dengue infection, but severe, persisting, myositis has not been reported.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  The patient is a 38 years old, HIV-negative male who developed sudden-onset fever up to 40.0 degrees C, headache, and sore eyes upon looking into light when on holidays in Thailand. One day after onset severe myalgias occurred in the shoulder girdle and hip girdle muscles. Clinical examination was normal, but blood work revealed elevated creatine-phosphokinase, glutamate-oxalate transaminase, and glutamate pyruvate transaminase, leucopenia and thrombocytopenia. Antibodies against Dengue viruses type 2 and 4 were positive and classical Dengue fever was diagnosed. The infection resolved upon symptomatic therapy, but myalgias, responsive only to opiates, resolved persistently not before the administration of corticosteroids, 2 months after onset.
  
  
  CONCLUSIONS
  The case shows that Dengue fever may also cause persisting, severe, myositis for weeks, which do not respond to non-steroidal analgesics, but promptly to corticosteroids.
authors.affiliation: Krankenanstalt Rudolfstiftung, Postfach 20, 1180 Vienna, Austria. duarte@aonmail.at
authors.forename: Josef
authors.initials: J
authors.lastname: Finsterer
authors.forename: Kittipong
authors.initials: K
authors.lastname: Kongchan
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D003715:Dengue / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D003716:Dengue Virus / Q000472:pathogenicity; D006801:Humans; D008297:Male; D009220:Myositis / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones