Abstract

ALTHOUGH dengue fever has been known for almost two centuries, a recent experience with atypical dengue infection is presented to draw attention to the milder expressions of the illness and to reappraise the clinical spectrum of this common tropical disease. Dengue was first described in 1779 from Java. Subsequently, Benjamin Rush 1 reported an epidemic occurring in Philadelphia and coined the colloquial term "breakbone fever." Henceforth, dengue was recognized only in its classical presentation 2 as a remitting fever characterized by abdominal pain, arthralgia, lymphadenopathy, severe bone pain, a diphasic dermal eruption and a positive Rumple-Leede test. In the 1920's, large scale outbreaks of the disease occurred in the Eastern Mediterranean and along the Gulf Coast of the United States. During World War II dengue was a major source of disability among military personnel in the Far East. In the Southwest Pacific Theater alone over 50,000 cases were encountered among

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