Rodriguez Lizis O, Levitt Eli B, Khamisani Nahal, Nickle Sarah, Izquierdo-Pretel Guillermo
Internal Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Translational Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Cureus. 2024 Jul 25;16(7):e65375. doi: 10.7759/cureus.65375. eCollection 2024 Jul.
Dengue is a significant global health concern, primarily prevalent in tropical and subtropical regions, affecting approximately 400 million people annually worldwide. This case report highlights the emergence of dengue in South Florida and raises concerns about the possibility of a local transmission. Unlike most cases, the patients discussed had not recently traveled, prompting the need for further investigation into the local transmission of dengue. In October 2023, two adult brothers presented to the Emergency Department (ED) with symptoms including fever, chills, nausea, vomiting, rash, severe headache, and syncope. Laboratory tests revealed thrombocytopenia, atypical lymphocytes, and elevated liver enzymes. With this clinical picture, dengue was suspected, and management was initiated accordingly. Both patients denied recent travel and had no known dengue infections in the past but had been exposed to mosquitoes a week prior. Both patients were managed with supportive treatment and platelet transfusions, which led to clinical improvement. However, the laboratory tests for dengue diagnosis had to be sent to a third-party laboratory, resulting in delayed confirmation of the disease. We received confirmation of a positive dengue serology approximately a week after the first patient was discharged. Two suspected cases of dengue virus were confirmed. The availability of local laboratory tests is crucial for the early diagnosis and management of dengue. The study calls for increased awareness of the disease's severity and its risk factors, emphasizing early recognition, judicious use of intravenous fluids, and the need for accessible local diagnostic resources to facilitate timely patient care.
登革热是一个重大的全球健康问题,主要流行于热带和亚热带地区,全球每年约有4亿人受其影响。本病例报告突出了南佛罗里达州登革热的出现,并引发了对本地传播可能性的担忧。与大多数病例不同,所讨论的患者近期没有旅行史,这促使有必要对登革热的本地传播进行进一步调查。2023年10月,两名成年兄弟因发热、寒战、恶心、呕吐、皮疹、严重头痛和晕厥等症状前往急诊科就诊。实验室检查显示血小板减少、非典型淋巴细胞增多以及肝酶升高。基于此临床症状,怀疑为登革热,并据此展开治疗。两名患者均否认近期有旅行史,过去也没有已知的登革热感染史,但一周前曾接触过蚊子。两名患者均接受了支持性治疗和血小板输注,病情得到了临床改善。然而,登革热诊断的实验室检查必须送往第三方实验室,导致疾病确诊延迟。第一名患者出院大约一周后,我们收到了登革热血清学阳性的确认结果。两例登革热病毒疑似病例得到确诊。本地实验室检查对于登革热的早期诊断和治疗至关重要。该研究呼吁提高对该疾病严重性及其危险因素的认识,强调早期识别、合理使用静脉输液,以及需要可获取的本地诊断资源以促进及时的患者护理。