Clinical manifestations and laboratory diagnosis

Abstract Dengue viral illness has a broad spectrum of clinical manifestation ranging from asymptomatic or subclinical to severe disease. It typically presents in three distinct phases, which are febrile phase, critical phase, and recovery phase. Febrile phase typically presents with a biphasic fever along with musculoskeletal pains and is often termed as “break bone fever.” A characteristic maculopapular rash may also be present. Hemorrhagic manifestations such as petechiae and bleeding from mucosal membrane may be seen. Patients may transition into the critical phase and have severe manifestations like plasma leakage and hemorrhagic tendencies leading up to organ failure and shock. In the recovery phase, hemodynamic status of the patient improves. A typical “isles of white in the sea of red” rash may be seen. Diagnosis is made with both clinical and laboratory diagnostic modalities. Confirmation of diagnosis often requires viral serology techniques.