A 32-year-old man, who is a military veteran, comes to the emergency department because of altered mental status. Two weeks ago, he returned from deployment for a peace-keeping mission in Taiwan. During his trip, he began developing high-grade fever, headaches, severe myalgias, and joint pains. He is sexually active and uses condoms inconsistently. His temperature is 38.7°C (101.7°F), pulse is 102/min, and blood pressure is 90/55 mm Hg.Examination shows a diffuse maculopapular rash, multiple purpuric lesions, and hepatomegaly. Laboratory studies show marked thrombocytopenia, leukopenia, and elevated liver aminotransferases. Which of the following is the most likely mechanism for this patient's current severe illness?

Question

A 32-year-old man, who is a military veteran, comes to the emergency department because of altered mental status. Two weeks ago, he returned from deployment for a peace-keeping mission in Taiwan. During his trip, he began developing high-grade fever, headaches, severe myalgias, and joint pains.  He is sexually active and uses condoms inconsistently. His temperature is 38.7°C (101.7°F), pulse is 102/min, and blood pressure is 90/55 mm Hg.Examination shows a diffuse maculopapular rash, multiple purpuric lesions, and hepatomegaly.  Laboratory studies show marked thrombocytopenia, leukopenia, and elevated liver aminotransferases.  Which of the following is the most likely mechanism for this patient's current severe illness?

Quizplus · Accepted Answer

Eductional Objective: Dengue viruses are single-stranded RNA viruses with 4 different serotypes.  Primary (first) infection can be asymptomatic or cause a self-limited disease in most adults.  Secondary infection is due to infection with a different viral serotype and usually causes more severe illness.

A 32-Year-Old Man, Who Is a Military Veteran, Comes to the Emergency