Exanthematic dengue fever mimicking rubella

Abstract

The authors present a case of dengue fever mimicking rubella. Male patient, in the second episode of dengue fever, presented afebrile, with diffuse morbilliform rash and craniocaudal progression, having subsequently affected his palms and soles. On the third day of clinical evolution, serologies did not indicate IgM, IgG, or NS1, but on the sixth day of evolution, IgM and IgG were reactive for dengue fever. Previous episodes of dengue are a risk factor for the development of more severe conditions, but this was atypical because the patient was afebrile and had a rubelliform rash. The case also illustrates an early IgG anamnestic response, as it was a reinfection.

Evaluation of Diagnostic Accuracy of Eight Commercial Assays for the Detection of Rubella Virus-Specific IgM Antibodies

“…This study included in the non-rubella panel, sera collected from confirmed cases of other viral agents that may present with symptoms similar to that of rubella (fever and rash). Sera from these cases may be subjected to rubella IgM testing as part of the differential diagnosis strategy or captured through case finding algorithms (7,8,(11)(12)(13)(14)(15). The Serion ELISA method in particular was prone to cross-reactivity with sera from cases of dengue, measles and parvovirus B19.…”

“…A panel of 238 sera was assembled that included in the non-rubella panel, sera IgM positive for chikungunya, dengue, measles, parvovirus B19, roseola and zika viruses. These viruses were chosen because they can also present with fever and rash symptoms and thus may be captured in rubella testing algorithms during differential diagnosis or active case finding (7,8,(11)(12)(13)(14)(15). Some, such as parvovirus B19, have been previously noted to be a source of cross-reactivity with methods for the detection of anti-rubella IgM antibody (16).…”