Wednesday, May 21, 2008

Dengue Rash: When do you suspect it is Dengue?

Day 3: Rash is resolving

This boy first came to the clinic on Tuesday with a widespread rash over the whole body. He had been treated with antibiotics for a sorethroat two weeks before and it was initially thought that the rash might have been due to antibiotics even though he had finished the course of antibiotics two weeks ago.

Day 2: Widespread rash with "islands of sparring"

The next day, the boy's rash got worse and you can see from the picture below how the rash covered almost the whole leg with just little areas of normal skin. This is known as a widespread rash with "islands of sparring" and is one of the ways a Dengue rash might look like.

A blood test was done which confirmed that the Dengue IgM was positive. This indicates that the child is having Dengue fever. However, the platelet count was still in the safe range, so the child is being managed at home but has to come to the clinic for daily blood tests to monitor the platelet count.

The child is otherwise quite active and the fever has subsided.

Parents can learn a few valuable lessons from this case:

1. Always seek medical attention if your child has a rash with fever.
2. Never assume a rash is due to antibiotics
3. Most Dengue cases can be managed at home and don't need hospitalization

For more info on Dengue click here

For my previous articles on Dengue please click here


Anonymous said...


I had a fever 4 days ago, with a sorethroat. I was given antibiotics and medicines for my fever and inflammation. I recovered 2 days ago, meaning fever has subsided and no more sore throat. However, i started to feel itchy on my hands and body yesterday, and it got worse today. I was thinking it could be due to drug allergy or worse, dengue. May I know when would it be appropriate to go for a blood test?

Really hope to hear from you soon. Thanks!

Eileen said...

Hi Dr. Tay,

From what I've read, dengue rash typically presents as a maculopapular rash with islets of sparing. In this boy's case, it appears to be more of an urticarial nature and thus looks more like an allergy. I understand that there are also atypical presentations of dengue rash, so how then can we decide when to suspect and test for dengue? (assuming there are no other cases/clusters in the vicinity of the patient's home). Thanks!