Capeding et al identified clinical findings which can help to identify an infant with dengue fever. The authors are from Research Institute for Tropical Medicine in Manila, San Pablo City Health Office, Armed Forces Research Institute for Medical Sciences in Bangkok and the University of Massachusetts in Worcester.
Patient selection: infant in an area where dengue fever occurs
Presenting features shared by dengue fever and by non-dengue acute febrile illness:
(1) cough and nasal congestion
(2) dyspnea
(3) cold hands and feet
(4) vomiting
(5) refusal to feed
Clinical findings suggestive of dengue fever at presentation:
(1) febrile seizures
(2) macular rash
(3) thrombocytopenia with a petechial rash
(4) drowsiness or lethargy
The higher the fever the more severe the dengue fever.
Additiona findings:
(5) flushing
(6) low to normal white blood cell count
Diagnosis depends on demonstrating dengue virus or the host response:
(1) IgM antibodies by ELISA may become positive 5 or more days after illness onset
(2) positive test for viral antigen (NS1)
(3) positive RT-PCR
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