Some patients of dengue may not have fever, warn Delhi AIIMS doctors

In rare cases, a person may be infected with the dengue virus without having any fever, doctors at AIIMS have said in a published case study.

Durgesh Nandan Jha | TNN
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NEW DELHI: In rare cases, a person may be infected with the dengue virus without having any fever, doctors at AIIMS have said in a published case study.

The case cited in the study was that of a nursing orderly working at the hospital who was diagnosed with dengue even though the 50-year-old did not have fever. The patient complained of fatigue which led doctors to call for a blood test. The tests revealed uncontrolled sugar and high levels of acid in the blood. The patient’s red cells, white cells and platelets were also very low, prompting the doctors to test him for dengue.

The result was positive on an NS1 antigen test and was re-confirmed with a reverse transcription polymerase chain reaction (RT-PCR) test for the dengue virus.

“.. in an endemic area, dengue should always be kept as an important differential diagnosis in patients with leucopenia (low white cell count) and severe thrombocytopenia (low platelet count), even in the absence of fever, especially during periods of outbreak,” the AIIMS doctors stated in the study, published in the latest issue of the Journal of The Association of Physicians of India.

They added that dengue patients who do not show fever are likely to be old, diabetic or suffering from other immunity compromised states.

According to Dr Rommel Tickoo, senior consultant, internal medicine at Max Saket, diabetics, cancer patients and those who have undergone transplant may show with fever when infected with dengue due to impaired immunity. “I have come across at least two to three such cases in the last few months. Such patients present with general weakness, low blood pressure and low platelet count. Dengue test is needed if there is no other explanation for the symptoms, especially in outbreak period,” he said.

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