Helbok Raimund, Dent Wolfgang, Gattringer Klaus, Innerebner Martha, Schmutzhard Erich
Department of Neurology, University of Innsbruck, Innsbruck, Austria.
Wien Klin Wochenschr. 2004;116 Suppl 4:58-60.
Dengue fever is a significant health problem in most tropical regions and increasingly observed among travelers returning from tropical countries. Clinical presentation might not be typical in patients from non-endemic areas. We report 2 patients returning from South-East Asia with proven Dengue-virus infection initially presenting with "febrile diarrhea" followed by hemorrhagic skin lesions during hospitalization. Blood and stool examination remained negative for bacteria, parasites and plasmodia. Dengue fever was suspected early, mainly due to the typical course of the complete blood cell count with thrombocytopenia (19 x 10(9)/L and 86 x 10(9)/L) and leucopenia (3 x 10(9)/L and 1.8 x 10(9)/L). Both patients had a benign clinical course, which still required intensive care monitoring. Platelet inhibitors and NSAIDs should be stopped when Dengue infection (Dengue fever and Dengue hemorrhagic fever) is suspected in order to minimalize the risk of bleeding. Although presentation of the disease might not always be typical, Dengue infection has to be considered early in the course of disease by taking an in-depth history and profound physical examination.
登革热在大多数热带地区是一个严重的健康问题，并且在从热带国家返回的旅行者中越来越多地被观察到。非流行地区的患者临床表现可能不典型。我们报告了2名从东南亚返回的患者，他们被证实感染了登革病毒，最初表现为“发热性腹泻”，住院期间随后出现出血性皮肤病变。血液和粪便检查细菌、寄生虫和疟原虫均为阴性。登革热早期被怀疑，主要是由于全血细胞计数的典型过程伴有血小板减少（分别为19×10⁹/L和86×10⁹/L）和白细胞减少（分别为3×10⁹/L和1.8×10⁹/L）。两名患者临床过程均为良性，但仍需要重症监护监测。当怀疑登革热感染（登革热和登革出血热）时，应停用血小板抑制剂和非甾体抗炎药，以将出血风险降至最低。尽管疾病表现可能并不总是典型的，但在疾病过程中早期通过深入询问病史和进行全面体格检查必须考虑登革热感染。
