A small number of patients with dengue may display atypical or unusual findings. The WHO terms this the expanded dengue syndrome.
Significance:
(1) misdiagnosis and/or delay in diagnosis
(2) presence of a second disorder
Atypical manifestations may include:
(1) encephalopathy or encephalitis
(2) convulsions/seizures
(3) transverse myelitis
(4) Guillain-Barre syndrome
(5) intracranial hemorrhage or thrombosis
(6) other central nervous system manifestations (transient paresis, altered consciousness, spasticity, etc)
(7) hepatitis including fulminant hepatic failure
(8) pancreatitis
(9) acute parotitis
(10) acute renal failure, including hemolytic uremic syndrome
(11) myocarditis and/or pericarditis
(12) cardiac conduction defects
(13) acute respiratory distress (ARDS)
(14) pulmonary hemorrhage
(15) myositis
(16) rhabdomyolysis
(17) hemophagocytic syndrome
(18) ITP
(19) spontaneous splenic rupture
(20) optic neuritis
(21) impaired visual acuity
(22) macular hemorrhage
(23) psychosis or hallucinations
(24) alopecia
Patients with dengue may also develop post-infectious fatigue syndrome.
