Dengue Geriatric Case Study Tropical Doctor 1 
Loss of appetite and strength in the geriatric population – diagnostic symptoms for dengue.
Ajay Hotchandani
Address: Mercy Clinic-NHI, 1955 Mercy Lane, Belize City, Belize
Email: mercyclinicmd@gmail.com
Keywords: dengue, geriatric, asymptomatic, loss of appetite, anorexia
Abstract:
In dengue endemic regions, a chief complaint of nocturnal fever often is a pathonomonic phrase that triggers an investigation for dengue. This article looks at cases of patients who were tested for dengue based on their symptoms of weakness and loss of appetite, without fever as fever was absent in most cases. The article also examines the changes in weight that occur after diagnosis of dengue and compares it to weight loss (if any), that occurred prior to the diagnosis. Dealing with the anorexia and weight loss is challenging for physicians, patients and family members.
Keywords: dengue, geriatric, appetite, anorexia, weakness, absent fever
Introduction:
Dengue is caused by the Dengue Virus (den1-4), which is a Flavivirus (RNA), spread via the Aedes aegypti mosquito. It is prevalent in the tropical climate countries, as the environment is ideal for breeding mosquitoes. Approximately 100 million people are affected by dengue yearly, making it the leading cause of illness and death worldwide [1]. Its effects range from asymptomatic to death due to fulminant shock and hemorrhage.
Symptoms include sudden onset of fever, headache, retroorbital pain, and back pain, along with severe myalgia giving rise to the colloquial designation “Break-bone fever”. Additional symptoms include anorexia, nausea or vomiting, marked cutaneous hypersensitivity and a macular rash, starting at the trunk and spreading to the extremities of the face [2]. Fever being the prevalent symptom, dengue is also often referred to as Dengue Fever. In a review of dengue on the following websites - CDC.gov, medicinenet.com, webmd.com, medlineplus.com and Wikipedia.com – anorexia is not listed as a
Ajay Hotchandani
Address: Mercy Clinic-NHI, 1955 Mercy Lane, Belize City, Belize
Email: mercyclinicmd@gmail.com
Keywords: dengue, geriatric, asymptomatic, loss of appetite, anorexia
Abstract:
In dengue endemic regions, a chief complaint of nocturnal fever often is a pathonomonic phrase that triggers an investigation for dengue. This article looks at cases of patients who were tested for dengue based on their symptoms of weakness and loss of appetite, without fever as fever was absent in most cases. The article also examines the changes in weight that occur after diagnosis of dengue and compares it to weight loss (if any), that occurred prior to the diagnosis. Dealing with the anorexia and weight loss is challenging for physicians, patients and family members.
Keywords: dengue, geriatric, appetite, anorexia, weakness, absent fever
Introduction:
Dengue is caused by the Dengue Virus (den1-4), which is a Flavivirus (RNA), spread via the Aedes aegypti mosquito. It is prevalent in the tropical climate countries, as the environment is ideal for breeding mosquitoes. Approximately 100 million people are affected by dengue yearly, making it the leading cause of illness and death worldwide [1]. Its effects range from asymptomatic to death due to fulminant shock and hemorrhage.
Symptoms include sudden onset of fever, headache, retroorbital pain, and back pain, along with severe myalgia giving rise to the colloquial designation “Break-bone fever”. Additional symptoms include anorexia, nausea or vomiting, marked cutaneous hypersensitivity and a macular rash, starting at the trunk and spreading to the extremities of the face [2]. Fever being the prevalent symptom, dengue is also often referred to as Dengue Fever. In a review of dengue on the following websites - CDC.gov, medicinenet.com, webmd.com, medlineplus.com and Wikipedia.com – anorexia is not listed as a
References: [1] Center for Disease Control, September 27, 2012, Dengue. CDC.gov. Retrieved September 17th, 2013, from http://www.cdc.gov/dengue [2] A.S. Fauci, E. Braunwald, K.J. Isselbacher and D.L. Kasper, “Harrison’s Principles of Internal Medicine” 14th edition, vol. 1, pp. 1136 [3] Simmons CP, Farrar JJ, Nguyen vV, Wills B (April 2012). "Dengue". N Engl J Med 366 (15): 1423–32 [4] WHO (2009). Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization. ISBN 92-4-154787-1. pp 32-37 [5] Manson A, Sheer S. Malnutrition in elderly ambulatory patients. Am J Public Health 1991;81:1195-97 [6] Morley JE. Why do physicians fail to recognize and treat malnutrition in older persons? J Am Geriatric Society 1991;39:1139-40 [7] Silver AJ, Morley JE, Strome LA, Jones D, Vickers L. Nutritional Status in Academic Nursing Home. J Am Geriatric Society 1988;36:487-91 [8] Wilson MG, Vaswani S, Liu D, Morely JE, Miller DK. Prevalence and causes of undernutrition in medical outpatients. Am J Med 1998;104:56-63