Which of the following is not a symptom of Dengue disease?

Appeared in: Raj. CHO -2020

Explanation

Dengue fever is classically defined by a sudden onset of a high-grade fever, often reaching 40°C (104°F).
While some dengue infections can be asymptomatic or mild, the characteristic clinical syndrome of 'Dengue Fever' involves a high fever.
Therefore, a mild fever is not considered a typical symptom of the disease when it becomes clinically apparent.

Option A: A sudden, high-grade fever is a hallmark and one of the primary diagnostic criteria for the febrile phase of dengue fever.
Option C: Pain behind the eyes, known as retro-orbital pain, is a classic and highly characteristic symptom of dengue fever.
Option D: Severe pain in the joints (arthralgia) and muscles (myalgia) is so prominent in dengue that it earned the name 'break-bone fever'.

Visual 1: Infographic - An infographic illustrating the three phases of dengue fever (febrile, critical, and recovery) with the key symptoms and warning signs for each phase.
Visual 2: Diagram - A diagram of the human body highlighting the areas typically affected by pain in dengue: head (headache), behind the eyes (retro-orbital pain), muscles, and joints.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of Dengue Fever helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must monitor patients with dengue for warning signs of progression to severe dengue (Dengue Hemorrhagic Fever/Dengue Shock Syndrome), which include severe abdominal pain, persistent vomiting, mucosal bleeding, and lethargy.
Patient education is critical. Advise patients to maintain hydration and to take paracetamol (acetaminophen) for fever and pain. Critically, they must avoid NSAIDs like ibuprofen and aspirin, as these can increase the risk of bleeding.
What if? If a patient with suspected dengue presents with a falling platelet count and a rising hematocrit, this is a major warning sign of plasma leakage and progression to the critical phase, requiring immediate fluid resuscitation and hospitalization.

How to Approach the Question

First, carefully read the question and identify the negative keyword 'not'. This means you are looking for the option that is NOT a symptom of dengue.
Recall the classic symptoms of dengue fever. A useful mnemonic is the triad: high fever, retro-orbital pain, and severe myalgia/arthralgia ('break-bone fever').
Evaluate each option against your knowledge of dengue symptoms.
Option A (High fever), Option C (Pain in the eyes), and Option D (Pain in the joints) are all well-known, classic symptoms.
By elimination, Option B (Mild fever) is the one that does not fit the typical clinical picture of symptomatic dengue.
Select the outlier as the correct answer.

Concept Tested & Keywords

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Lewis Medical Surgical Nursing p. 1234-1256

Practise the full Raj. CHO -2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.