Abdul Khalid Awan, Imtiaz Ahmed, Ashfaque Ahmed, Khusheed Lone, Robina Rafique, Manzoor Haidri, Muhammad Riaz.
Clinical Manifestations of Dengue in a Recent Outbreak in Muzaffarabad.
Int J Pathol Jan ;14(4):148-53.

Objective: Assessment of clinical manifestations of dengue fever in area of Muzaffarabad during first ever outbreak of dengue fever. Design: Prospective, cross sectional Material & Methods: Patients who were diagnosed as suffering from dengue fever were included in the study. Clinical manifestations of all patients were recorded in study Performa designed for the study. All routine laboratory investigations including Blood complete examination including platelet counts, total leukocyte count and hematocrit, Blood Sugar, Urea, Creatinine, Serum Electrolytes, LFTS and Urine examination were performed in all patients. The diagnosis of dengue fever was confirmed with serological tests (NS1 Antigen or IgM/IgG Anti-dengue virus antibody titers). Results: In most patients, typical diagnostic clinical findings on physical examination were high fever (1020 to 1040 F), suffused conjunctivae (45%) and facial flushing (82%) including external ears. The other prominent feature was diffuse erythematous rash (18%) over extremities and truck. The early features at presentation were facial flushing and suffused conjunctivae while rash appeared after 3-4 days of febrile illness in most patients. There was only small percentage (5%) of patients with insignificant cervical lymphadenopathy. Conclusion: Dengue fever has become an emerging significant health problem in our country. It is imperative to have updated and sound knowledge of clinical manifestations of dengue fever, otherwise; many cases of dengue fever will be misdiagnosed due to inappropriate assessment and misinterpretation of clinical signs and symptoms.

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