ICD-10: A90

Dengue fever, classified under ICD-10 code A90, is a viral infection transmitted primarily by Aedes mosquitoes, particularly Aedes aegypti. This disease is prevalent in tropical and subtropical regions, affecting millions of people worldwide each year. Below is a detailed clinical description and relevant information regarding classical dengue fever.

Clinical Description of Dengue Fever

Etiology

Dengue fever is caused by the dengue virus, which belongs to the Flavivirus genus. There are four distinct serotypes of the virus (DEN-1, DEN-2, DEN-3, and DEN-4), and infection with one serotype typically provides lifelong immunity to that specific serotype but not to the others. Subsequent infections with different serotypes can lead to more severe forms of the disease, such as dengue hemorrhagic fever or dengue shock syndrome[1].

Symptoms

The clinical presentation of dengue fever typically occurs 4 to 10 days after being bitten by an infected mosquito. Symptoms can vary in severity and may include:

• High fever: Sudden onset of fever, often reaching up to 40°C (104°F).
• Severe headache: Intense pain, often located behind the eyes.
• Joint and muscle pain: Commonly referred to as "breakbone fever" due to the severity of the pain.
• Nausea and vomiting: Gastrointestinal symptoms may accompany the fever.
• Fatigue: General malaise and weakness are prevalent.
• Rash: A rash may appear a few days after the onset of fever, which can be maculopapular or petechial in nature.

Diagnosis

Diagnosis of dengue fever is primarily clinical, supported by laboratory tests. Key diagnostic methods include:

• Serological tests: Detection of dengue-specific IgM and IgG antibodies.
• Polymerase chain reaction (PCR): Identification of viral RNA in blood samples, particularly useful in the early stages of the disease.
• NS1 antigen detection: A rapid test that can identify the dengue virus during the acute phase of infection[2].

Management

There is no specific antiviral treatment for dengue fever. Management focuses on supportive care, which includes:

• Hydration: Oral or intravenous fluids to prevent dehydration.
• Pain relief: Acetaminophen (paracetamol) is recommended for fever and pain relief, while non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided due to the risk of bleeding.
• Monitoring: Close observation for signs of severe disease, especially in patients with warning signs such as severe abdominal pain, persistent vomiting, or bleeding[3].

Prognosis

Most cases of classical dengue fever are self-limiting, with recovery typically occurring within one to two weeks. However, vigilance is necessary, as some patients may progress to more severe forms of the disease, which can be life-threatening.

Conclusion

Dengue fever, classified under ICD-10 code A90, is a significant public health concern in many regions. Understanding its clinical features, diagnostic methods, and management strategies is crucial for healthcare providers to effectively treat and prevent complications associated with this viral infection. Continued research and public health initiatives are essential to control the spread of dengue and improve patient outcomes.

[1] Source: General knowledge on dengue virus and its serotypes.
[2] Source: Common diagnostic methods for dengue fever.
[3] Source: Management strategies for dengue fever.

Dengue fever, classified under ICD-10 code A90, is a viral infection transmitted primarily by Aedes mosquitoes, particularly Aedes aegypti. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and management.

Clinical Presentation

Dengue fever typically presents with a sudden onset of fever, often accompanied by a range of systemic symptoms. The incubation period for the virus is usually between 4 to 10 days after being bitten by an infected mosquito. The clinical course can vary significantly among patients, with some experiencing mild symptoms while others may develop severe manifestations.

Common Signs and Symptoms

1. Fever: The hallmark of dengue fever is a high fever, often reaching up to 40°C (104°F), which can last for 2 to 7 days[1].

2. Headache: Severe headaches, often described as retro-orbital pain (pain behind the eyes), are common[1].

3. Muscle and Joint Pain: Patients frequently report significant muscle and joint pain, leading to the term "breakbone fever" due to the intensity of the discomfort[1][2].

4. Rash: A rash may develop, typically appearing 3 to 4 days after the onset of fever. It can be maculopapular and may spread to most parts of the body[2].

5. Nausea and Vomiting: Gastrointestinal symptoms such as nausea, vomiting, and loss of appetite are also prevalent[1].

6. Fatigue: Patients often experience extreme fatigue and malaise, which can persist even after the fever subsides[2].

7. Hemorrhagic Manifestations: In some cases, particularly in severe dengue, patients may exhibit signs of bleeding, such as petechiae (small red or purple spots), nosebleeds, or gum bleeding[1].

Severe Dengue

While most cases of dengue fever are self-limiting, some patients may progress to severe dengue, characterized by plasma leakage, severe bleeding, organ impairment, or death. This progression is more common in individuals with a previous dengue infection due to antibody-dependent enhancement of the virus[1][2].

Patient Characteristics

Dengue fever can affect individuals of all ages, but certain characteristics may influence the severity and outcomes of the disease:

1. Age: Children and young adults are often more susceptible to severe forms of dengue, although adults can also experience severe symptoms[2].

2. Previous Infection: Individuals with a history of previous dengue infections are at a higher risk for developing severe dengue upon subsequent infections[1].

3. Underlying Health Conditions: Patients with pre-existing health conditions, such as diabetes, hypertension, or other chronic illnesses, may experience more severe symptoms and complications[2].

4. Geographic Location: The incidence of dengue fever is higher in tropical and subtropical regions, where the Aedes mosquito is prevalent. Areas with recent outbreaks may see increased cases among the local population[1].

5. Immunocompromised Status: Patients with weakened immune systems may be at greater risk for severe manifestations of the disease[2].

Conclusion

Dengue fever, classified under ICD-10 code A90, presents with a variety of symptoms that can range from mild to severe. Recognizing the clinical signs and understanding patient characteristics are essential for timely diagnosis and management. Awareness of the potential for severe dengue, especially in at-risk populations, is crucial for healthcare providers in endemic regions. Early intervention can significantly improve patient outcomes and reduce the risk of complications associated with this viral infection.

Dengue fever, classified under ICD-10 code A90, is a viral infection transmitted primarily by mosquitoes, particularly the Aedes aegypti species. While "Dengue fever" is the most commonly used term, there are several alternative names and related terms that can be associated with this condition. Below is a detailed overview of these terms.

Alternative Names for Dengue Fever

1. Classical Dengue: This term specifically refers to the non-severe form of dengue fever, distinguishing it from more severe manifestations such as Dengue Hemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS) [1].

2. Dengue: Often used interchangeably with "Dengue fever," this term encompasses all forms of the disease, including severe and non-severe cases [1].

3. Breakbone Fever: This colloquial name arises from the severe joint and muscle pain that can accompany the illness, making patients feel as though their bones are breaking [1].

4. Dengue Virus Infection: This term emphasizes the viral nature of the disease, highlighting that it is caused by the dengue virus, which has four distinct serotypes (DEN-1, DEN-2, DEN-3, and DEN-4) [1].

Related Terms

1. Dengue Hemorrhagic Fever (DHF): A severe form of dengue characterized by bleeding, plasma leakage, and potentially fatal complications. It is classified under a different ICD-10 code (A91) [1].

2. Dengue Shock Syndrome (DSS): Another severe manifestation of dengue, where patients experience shock due to severe plasma leakage. This condition is also classified separately in the ICD-10 system [1].

3. Aedes Mosquito: The primary vector responsible for the transmission of the dengue virus. Understanding the role of this mosquito is crucial in the context of dengue prevention and control [1].

4. Viral Hemorrhagic Fever: A broader category that includes dengue hemorrhagic fever, as well as other viral infections that can cause bleeding and shock [1].

5. Tropical Disease: Dengue fever is often categorized as a tropical disease due to its prevalence in tropical and subtropical regions around the world [1].

Conclusion

Dengue fever, or classical dengue, is a significant public health concern, particularly in tropical regions. Understanding the various alternative names and related terms is essential for healthcare professionals and researchers working in infectious diseases. This knowledge aids in accurate diagnosis, treatment, and communication regarding the disease and its implications. If you have further questions or need more specific information, feel free to ask!

Dengue fever, classified under ICD-10 code A90, is a viral infection transmitted primarily by Aedes mosquitoes. The diagnosis of dengue fever involves a combination of clinical evaluation and laboratory testing. Below are the key criteria used for diagnosing classical dengue fever:

Clinical Criteria

1. Symptoms: The presence of typical symptoms is crucial for diagnosis. Common symptoms of dengue fever include:
   - High fever (often sudden onset)
   - Severe headache
   - Pain behind the eyes
   - Joint and muscle pain (often referred to as "breakbone fever")
   - Nausea and vomiting
   - Fatigue
   - Skin rash, which may appear a few days after the onset of fever

2. Epidemiological Link: A history of travel to or residence in an area where dengue fever is endemic or where outbreaks have been reported is an important factor. This context helps to establish the likelihood of exposure to the virus.

3. Physical Examination: Clinicians may look for signs such as:
   - Hemorrhagic manifestations (e.g., petechiae, bleeding gums)
   - Signs of dehydration
   - Abdominal tenderness

Laboratory Criteria

1. Serological Tests: Laboratory tests can confirm the diagnosis of dengue fever. These include:
   - Dengue NS1 antigen test: This test detects the presence of the dengue virus protein and is most effective during the first few days of illness.
   - Dengue IgM and IgG antibody tests: These serological tests help identify recent or past infections. IgM antibodies typically appear within a week of infection, while IgG indicates a past infection.

2. Polymerase Chain Reaction (PCR): This molecular test can detect the viral RNA in the blood and is particularly useful in the early stages of the disease.

3. Complete Blood Count (CBC): A CBC may show thrombocytopenia (low platelet count) and leukopenia (low white blood cell count), which are common in dengue infections.

Diagnostic Considerations

• Differential Diagnosis: It is essential to differentiate dengue fever from other febrile illnesses, such as chikungunya, Zika virus, and other viral hemorrhagic fevers, especially in endemic areas.
• Severity Assessment: While A90 refers to classical dengue fever, it is important to assess the severity of the disease, as dengue can progress to severe dengue (previously known as dengue hemorrhagic fever), which requires different management strategies.

In summary, the diagnosis of dengue fever (ICD-10 code A90) relies on a combination of clinical symptoms, epidemiological history, and laboratory tests. Accurate diagnosis is critical for effective management and to prevent complications associated with the disease.

Dengue fever, classified under ICD-10 code A90, is a mosquito-borne viral infection characterized by high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, and mild bleeding. While there is no specific antiviral treatment for dengue, management focuses on supportive care and symptom relief. Here’s a detailed overview of standard treatment approaches for classical dengue fever.

Supportive Care

Hydration

One of the most critical aspects of managing dengue fever is maintaining adequate hydration. Patients are encouraged to drink plenty of fluids, including water, oral rehydration solutions, and electrolyte-rich beverages. In severe cases, intravenous (IV) fluids may be necessary to prevent dehydration, especially if the patient exhibits signs of shock or severe bleeding[1][2].

Pain and Fever Management

To alleviate pain and reduce fever, acetaminophen (paracetamol) is the preferred medication. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin should be avoided, as they can increase the risk of bleeding complications associated with dengue[3][4].

Monitoring

Patients with dengue fever should be closely monitored for any signs of deterioration, particularly during the critical phase of the illness, which typically occurs between days 3 to 7 of the illness. This includes monitoring vital signs, hematocrit levels, and platelet counts to detect any potential complications early[5].

Hospitalization Criteria

Severe Dengue

Patients exhibiting severe dengue symptoms, such as severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, or liver enlargement, may require hospitalization. In a hospital setting, more intensive monitoring and treatment can be provided, including blood transfusions if necessary[6].

Management of Complications

In cases of severe dengue, management may involve:
- Fluid Resuscitation: Administering IV fluids to maintain blood pressure and organ perfusion.
- Blood Product Transfusion: If there is significant bleeding or low platelet counts, transfusions may be necessary.
- Supportive Care: Continuous monitoring and supportive measures to manage complications such as organ failure[7].

Prevention Strategies

While treatment focuses on managing symptoms, prevention remains crucial in controlling dengue outbreaks. Key strategies include:
- Vector Control: Reducing mosquito populations through environmental management and insecticide use.
- Personal Protection: Encouraging the use of mosquito repellents, wearing long-sleeved clothing, and using bed nets to prevent bites.
- Vaccination: The Dengvaxia vaccine is available in some regions for individuals who have had a previous dengue infection, as it can help reduce the severity of subsequent infections[8].

Conclusion

In summary, the management of classical dengue fever (ICD-10 code A90) primarily involves supportive care, hydration, and pain management. Close monitoring is essential to identify and address any complications early. While there is no specific antiviral treatment, effective management strategies can significantly improve patient outcomes. Preventive measures remain vital in controlling the spread of dengue and protecting at-risk populations.