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Q. I have fever, weakness and throbbing of head. Do I have dengue?

Answered by
Dr. Ashaq Hussain Parrey
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 29, 2017

Hi doctor,

On 16th evening, I suddenly fell sick with symptoms like fever, sudden fatigue, chills, body aches (chest, legs, shoulders, head, eyes, almost all body). I was good during the day except for an itching in the throat. The weakness was so severe that I could not even walk a few steps. I felt like I was going to collapse. Yesterday, I visited a physician who advised me to undergo few blood tests. He thought I am having dengue. Today, I received my blood reports. The dengue tests were negative. But the CBC reports suggest an infection. I still have a similar weakness that I had during the onset of fever. When I walk, I feel like my head is throbbing and it would burst. I almost hold it by my hand to suppress the pain. The body ache seems to be reduced as I am taking Calpol twice a day. Do I really have dengue? Did the test turn negative as I did it before 24 hours of onset of fever? Do you suggest to undergo any other test like chikungunya and yellow fever? Or is it just 'atypical' viral fever? I am currently on Azithromycin once a day, Paracetamol twice a day, and Allegra twice a day.

#

Hello,

Welcome to icliniq.com.

I went through your post and investigations (attachment removed to protect patient identity).

  • It is sure you had a viral fever. It looks like either influenza virus or dengue. Anyway, if your fever has subsided that means you have started developing an immunity to the infecting virus and the treatment is always symptomatic.
  • Your platelet count is normal. Both dengue and influenza are self-limiting and need only symptomatic treatment unless there is a low platelet count or respiratory distress.
  • Instead of Calpol (Paracetamol 500 mg), I would suggest you take tablet Dolo (Paracetamol 650 mg) 650 three times a day. That will decrease the headache.
  • Take plenty of fluids. Do not exert too much. Take rest at home. You should be better in about 36 to 48 hours which is the natural course of the illness. However, you may have to repeat the CBC to keep watch on the platelet count.

Regards.

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

I still have fever and a severe headache while making any movement. It has been 48 hours since the onset of fever and other symptoms. Should I go for the dengue tests again? Do you suspect any other cause of infection other than influenza? Should I undergo any other tests like chikungunya? Three months ago, my platelet count was 210 mi which has dropped to 150 mi. There was no major illness between these months. When should I undergo CBC again?

#

Hello,

Welcome back to icliniq.com.

  • You can get tested for chikungunya. But, there is no need for dengue. As I said, the symptoms start improving after 72 hours. You have already passed 48 hours, and in the next 36 to 48 hours, you should be fine.
  • You can repeat the CBC (complete blood count) tomorrow. If the platelet count is more than 70,000, then there is nothing to worry. You may have some drop in the platelet count because all viral infections decrease the platelet count due to bone marrow suppression. However, if the count is more than 60,000, then it is not a problem. If it is below this, one may need hospitalization.
  • The best thing is most acute viral infections are self-limiting where the recovery starts after 72 hours, and there is a complete resolution in seven to 10 days.

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

Two days ago, I got another CBC done. I am not taking medications since the last three days as I have completed the course. Currently, I have the following problems: A lot of swellings (bulges) with pus similar to boils. These are all over the lining of the nostrils, the passage from the nose to upper lip, on the upper lip and the corners of the lower lip. (attached image). I have a runny nose with thick, sticky mucus. It really becomes difficult to drain this out because of above boils. Sore throat is there from day-1 and has not improved. Though not severe, it aches while swallowing food or saliva. A migraine, especially in the neck area and above. A cough, though not severe, but it is there. In the morning I cough phlegm but afterward, it is not that wet. Considering that I am now in the sixth day of this illness, can you provide the further line of treatment, especially for those boils, sore throat and cough?

#

Hello,

Welcome back to icliniq.com.

I have seen the images of the boils (attachment removed to protect patient identity).

  • You have developed herpes around the mouth and nose because of fever. For that, you will have to use Acyclovir cream locally.  Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent.
  • You also have superimposed bacterial infection of the throat. I suggest you start Levofloxacin 500 mg once daily.
  • I am expecting you to be in normal health in the next three days.

Regards.

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician


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