This is a 50-year-old woman who smokes occasionally.
His personal history included a nine-day tourist trip to Rivera Maya (Mexican Caribbean), fifteen days before the onset of symptoms.
During the trip, the patient, as she said, suffered numerous mosquito bites.
In the 48 hours prior to consultation, the patient was self-treated with acetyl salicylic acid (AAS) as an antipyretic and symptomatic treatment of headache.
On physical examination the patient was conscious, oriented and febricular (37.6oC), TA=110/70.
There was facial flushing and bilateral conjunctival injection as well as the presence of a hemorrhagic, symmetrical, maculo-papular rash on trunk and extremities, especially in the lower limbs, where it was confluent, and not in vitro.
In the rest of the examination by equipment, the presence of numerous laterocervical and retrocervical adenopathies as well as preauricular lymph nodes was identified.
No meningismus or hepatomegaly were observed.
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The snare test (Rumpell-Leade) showed the appearance of more than 30 petechiae in the right antecubital fossa.
A hematologic exam was performed, showing normal erythrocytes 4.90x106/microL with 43% hematocrit and platelets.
In the white series, the count determined 7,700 leukocytes with relative lymphopenia (22%) and the presence of numerous activated lymphocytes.
The ESR was 28 mm in the first hour, with CRP=6.62 mg/dL.
Coagulation tests were normal for both pathways.
Biochemistry showed a creatinine of 1.28 mg/dl with ALT transaminitis = 78 U/L. The thick blood smear and blood extension was negative.
Finally in the immunological analysis were determined: negative IgMAgM against CMV, HBcAg, HBsAg and negative HBsAg, IgMAg against P. falciparum negative and IgMAg positive against dengue
In the study of thick blood smears and blood extension, the presence of congenital syphilis was not detected.
The patient was diagnosed with classic dengue with probable criteria of hemorrhagic dengue fever grade 1 caused by ASA.
After removal, the patient completely recovered within 10 days.
