An 8-year-old boy with dengue fever develops abdominal pain and persistent vomiting on day 5. Examination reveals restlessness, cold clammy extremities, rapid weak pulse of 140/min and blood pressure of 82/50 mmHg. Haematocrit has risen by 25% and there is bilateral pleural effusion. This presentation corresponds to:

• A Dengue fever without warning signs
• B Dengue haemorrhagic fever Grade II
• C Dengue haemorrhagic fever Grade IV
• D Dengue haemorrhagic fever Grade III ✓

Explanation

Grade III DHF is defined by plasma leakage with evidence of circulatory failure such as weak thready pulse, narrow pulse pressure (20 mmHg or less) or hypotension, with the patient remaining conscious. Grade IV is distinguished by profound shock with undetectable blood pressure and pulse, which this child does not have. Grade I lacks spontaneous bleeding and shock, and Grade II adds spontaneous bleeding without circulatory failure.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.