Dengue Fever (cont.)
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Diagnosis of Dengue Fever
Dengue fever is presumptively diagnosed by a medical caregiver by the relatively characteristic sequence of high fever, rash appearance, and other symptoms in a person who has a history of recent travel to dengue endemic areas and recalls mosquito bites while in the endemic area. However, if not all of the symptoms or history is complete, the caregiver is likely to run a number of tests to obtain a definitive diagnosis. Other diseases may yield similar symptoms (for example, leptospirosis, typhoid fever, yellow fever, scarlet fever, Rocky Mountain spotted fever, meningococcemia, and several others) if the patient has severe symptoms; or if the medical caregiver does not have enough information to make a presumptive diagnosis, the patient is likely to undergo a number of other tests to definitively distinguish dengue fever from other diseases. In general, the more serious the symptoms such as easy bruising, fevers at or above 104 F, hemorrhages or shock syndrome, the more tests are likely to be done.
In general, most clinicians will order a complete blood test (CBC), with a metabolic panel, along with coagulation studies in most patients with high fever and any bleeding problems. In addition, depending on the symptoms (especially headache) and the clinician, blood and urine cultures plus a spinal tap may be done to help differentiate between dengue fever and other diseases. A MAC-ELISA assay (an immunoglobulin M-based test) is the most widely used test for dengue fever virus. However, other tests are available; they also are based on the person's immunological response to the dengue serovars (for example, IgG-ELISA, dengue viral plaque reduction tests, and PCR tests). These tests are considered definitive for exposure to dengue virus; definitive diagnosis of dengue fever is isolation and identification (usually by immunological tests) of the dengue virus serovar from the patient.
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