A 6-year-old boy presents with high-grade fever for 5 days, severe headache, retro-orbital pain, myalgias, and a positive tourniquet test. On day 5 of illness, he develops abdominal pain, persistent vomiting, and tender hepatomegaly. Platelet count is 40,000/mm3 and hematocrit has risen by 25% from baseline. Which is the most appropriate diagnosis?
- A Dengue fever with warning signs ✓
- B Dengue fever without warning signs
- C Dengue haemorrhagic fever (DHF) grade I
- D Dengue haemorrhagic fever (DHF) grade III
Correct answer: A. Dengue fever with warning signs
Explanation
The child has dengue fever (fever, retro-orbital pain, positive tourniquet test) plus warning signs: abdominal pain, persistent vomiting, tender hepatomegaly, and rising hematocrit. DHF requires plasma leakage proven by pleural effusion, ascites, or hemoconcentration with thrombocytopenia; DHF grade III requires impending shock. Here, only warning signs are present, fitting 'dengue with warning signs' per WHO classification.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.