A patient presented to emergency depament with sudden onset of fever, headache, retro orbital pain, and back pain. Dengue was suspected. Which is the most sensitive diagnostic test for dengue?: (A) IgM ELISA, (B) CFT, (C) Tissue culture, (D) Electron microscopy
Answer is A. After an incubation period of 2-7 days, the typical patient experiences the sudden onset of fever, headache, retro orbital pain, and back pain along with the severe myalgia that gave rise to the colloquial designation "break-bone fever." Laboratory findings include leukopenia, thrombocytopenia, and, in many cases, serum aminotransferase elevations. The diagnosis is made by IgM ELISA or paired serology during recovery or by antigen-detection ELISA or -PCR during the acute phase. Ref: Peters C.J. (2012). Chapter 196. Infections Caused by Ahropod- and Rodent-Borne Viruses. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.