DENGUE - A REPORT OF 2 CASES

Background. Dengue is an acute febrile illness caused by several arthr opod-born viruses and characterized by biphasic fever, myalgia or arth ralgia, rash, leukopenia and lymphadenopathy. Its diagnosis is based o n knowledge of the geographic distribution of dengue viruses. Case rep orts Case n-degree 1: A 11 year-old boy suffered from sudden onset of fever accompanied by retro-orbital headache, arthralgia and diffuse my algia. There was no rash. Hemogram showed: hemoglobin: 11.6 g%; leukoc ytes: 3 400/mm3 (PMN: 76%); platelets: 190 000/mm3. A diagnosis of vir al infection was considered, but, as the boy had recently been to the French West-Indies, a serologic study was performed. This was negative 2 days after the onset of disease and positive (specific IgM for the 4 dengue types), 13 days later. Case n-degree 2: A 7 year-old-boy suff ered from sudden onset of fever. Severe calf muscle pain 4 days later led to his admission. Creatine phosphokinase activity was very high: 8 3 100 units (N: 30-120). Hemogram showed: hemoglobin: 11.4 g%; leukocy tes: 2 500/mm3 (PMN: 60%); platelets: 124 000/mm3. A diagnosis of acut e myositis was considered, but as the patient had recently visited Ven ezuela, a serologic study was performed. This was negative 8 days afte r the onset of disease and positive (specific IgM for the 4 dengue typ es) 16 days later. Conclusion. The first case is characteristic of the classical form of dengue fever. The second patient presented with ver y localized myalgia. The diagnosis in both cases was facilitated by th e knowledge that the patient had recently stayed in an endemic area.