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Dengue Fever — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesDengue FeverRACP Adult Medicine

A 30-year-old woman recently returned from Southeast Asia presents with a 5-day history of high fever, headache, myalgia, and a petechial rash. Her platelet count is 45 × 10⁹/L, haematocrit is rising, and she has abdominal pain with pleural effusion on CXR. What is the most likely diagnosis?

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Correct answer: D — Dengue fever with warning signs

Dengue fever with warning signs includes abdominal pain/tenderness, persistent vomiting, clinical fluid accumulation (pleural effusion, ascites), rising haematocrit with falling platelets, and mucosal bleeding. This patient meets criteria for dengue with warning signs. Management is supportive with careful IV fluid therapy (avoid overhydration). NSAIDs/aspirin should be avoided. Platelet transfusion is rarely indicated.

Reference: WHO – 2024 – Dengue Guidelines; CDNA – 2024 – Dengue National Guidelines