Dengue for surgeons

Despite what is in the textbooks Dengue patients do not always develop rashes till the platelet levels have fallen waay down and even then hemorrhage may be sudden. Today i saw a patient in emergency who was complaining of pain in right upper abdomen and had fever for last 2 days. I had a suspicion of liver abscess and to confirm i got a ultrasound examination done. The radiologist found inflammation of gallbladder without any stones suggestive of dengue and it was confirmed as such. Quite a number of patients present with upper abdominal pain with fever and it has happened quite a few times that on clinical examination i have suspicion of Acute cholecystitis which on ultrasound examination is suggestive of dengue and later confirmed as such. Discussion of dengue from surgical point of view can be seen here .