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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Mary Nettleman, MD, MS, MACP

Mary Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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The symptoms and signs for dengue begin about three to 15 days after a mosquito bite transfers a virus (dengue virus serotype 1-4) to a person previously unexposed to the viruses. Fever and painful muscle and joint aches can occur during the first few hours of symptoms when headache, chills, rash, and swollen lymph nodes first appear. Pain behind the eyes is also a common symptom. These symptoms usually last about two to four days and then diminish, only to reappear again with a rash that covers the body and spares the face. The rash also may occur on the palms of the hands and the bottom of the feet, areas frequently spared in many viral and bacterial infections. The symptoms may last about one to two weeks with complete recovery, in most cases, in a few weeks. However, some people can develop more severe symptoms and complications, such as hemorrhagic areas in the skin, gums, and the gastrointestinal tract. This clinical problem is termed dengue hemorrhagic fever (DHF). The majority of DHF is seen in children under 15 years of age, but it can occur in adults. Another clinical variation of dengue fever is termed dengue shock syndrome (DSS); DHF usually precedes DSS. The patients eventually develop severe abdominal pain, heavy bleeding, and blood pressure drops; this syndrome, if not treated quickly, may cause death.

Figure 1: Rash on legs due to dengue fever; image reprinted with permission from eMedicine.com, 2009, photo courtesy of Duane Gubler, PhD

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