Abstract
Dengue infection may manifest as dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). The World Health Organization (WHO) came up with the term "expanded dengue syndrome" (EDS) to designate cases which do not fall into either DHF or DSS, with unusual manifestations in other organs such as the cardiovascular system, the nervous system, the kidneys, the gut, and the hematological system, which have been increasingly reported and called EDS. Furthermore, EDS is becoming widespread globally with unusual features and increased severity. There are increasing reports of under-recognized and infrequent manifestations with severe organ involvement. This review gives knowledge of expanded dengue syndrome which helps to catch the diagnosis of dengue early, particularly during the ongoing epidemics and escaping from further series of unnecessary investigations.
Highlights
BackgroundDengue is caused by a vector-borne arbovirus of the flavivirus family
Apart from the common classical presentation, dengue infection can result in a spectrum of uncommon clinical manifestations, which are grouped under the term - expanded dengue syndrome (EDS) [5]
Dengue infection may manifest as an asymptomatic dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS)
Summary
Dengue is caused by a vector-borne arbovirus of the flavivirus family. It is transmitted by the female mosquitoes Aedes aegypti, Aedes albopictus, Aedes scutellaris, and Aedes polynesiensis. Apart from the common classical presentation, dengue infection can result in a spectrum of uncommon clinical manifestations, which are grouped under the term - expanded dengue syndrome (EDS) [5]. Regardless of the dogged grouping of dengue into DF, DHF, and DSS, the overlap between the different manifestations could be observed End organ damage, such as liver, kidney, heart, brain, and bone marrow involvement, has been mostly reported in severe dengue with plasma leakage, or bleeding, which may confuse the clinicians. EDS is a term announced by the WHO in 2011 to cover the uncommon expressions of dengue involving severe damage to the liver, kidneys, bone marrow, heart, or brain [6] They may be related to underlying comorbidities, associated co-infections, or prolonged shock. Idiopathic thrombocytopenic purpura (ITP) and pancytopenia, with bone marrow biopsy revealing aplastic anemia, have been described following dengue fever [35]
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