This is a 23-day-old female patient from the rural area of Carepa, who was taken to the hospital emergency department with fever of six days of evolution and four days of rhinorrhea.
The day before the consultation she had two episodes of epistaxis.
On admission, the patient was hypoactive, with generalized urticaria and signs of epistaxis in the right nostril, axillary temperature of 37.5 °C, heart rate of 96 per minute and respiratory rate of 32 per minute.
Hepatomegaly was found in the abdomen.
With this history a diagnostic impression of dengue with hemorrhagic manifestations was made and treatment with fluids and antipyretics was started.
Paraclinical tests at admission reported values of hemoglobin 6.5 g/dl, hematocrit 18.4%, leukocyte count 8,600/ml, platelet count 30,000/μl, total bilirubin 2.2 mg/dl which persisted with fever alive.
With this result, treatment with chloroquine was initiated.
The patient showed improvement of her fever.
Despite his hematological status, no intervention was performed.
On the sixth day he was discharged.
