COVID-19 mimicking dengue fever with the initial manifestation of retro-orbital pain – A Rare Case

Ruiy, Walis; Hsu, Shih-Yung; Tsai, Hsien-Lung; Chen, Chen-Te; Tseng, Chih-Peng; Chen, Wei-Teing

doi:10.1016/j.jfma.2020.05.039

Cited by 15 publications

(14 citation statements)

References 4 publications

(2 reference statements)

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“…In this framework, the relevance of body ache, headache and retro-orbital pain at presentation for the differential diagnosis between COVID-19 and dengue accounts for the involvement of dengue in the general and digestive spheres, as proposed by Nacher et al in a recent opinion paper, COVID-19 being more pronounced in the respiratory sphere [10]. Interestingly, we also found one COVID-19+ case who was tested negative for dengue suffering retro-orbital pain, as previously reported in Taiwan [13].…”

Section: Discussionsupporting

confidence: 88%

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Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: A cohort study in a SARS-CoV-2 testing center on Reunion island

et al. 2021

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Background As coronavirus 2019 (COVID-19) is spreading globally, several countries are handling dengue epidemics. As both infections are deemed to share similarities at presentation, it would be useful to distinguish COVID-19 from dengue in the context of co-epidemics. Hence, we performed a retrospective cohort study to identify predictors of both infections. Methodology/Principal findings All the subjects suspected of COVID-19 between March 23 and May 10, 2020, were screened for COVID-19 within the testing center of the University hospital of Saint-Pierre, Reunion island. The screening consisted in a questionnaire surveyed in face-to-face, a nasopharyngeal swab specimen for the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain-reaction and a rapid diagnostic orientation test for dengue. Factors independently associated with COVID-19 or with dengue were sought using multinomial logistic regression models, taking other febrile illnesses (OFIs) as controls. Adjusted Odds ratios (OR) and 95% Confidence Intervals (95%CI) were assessed. Over a two-month study period, we diagnosed 80 COVID-19, 61 non-severe dengue and 872 OFIs cases eligible to multivariate analysis. Among these, we identified delayed presentation (>3 days) since symptom onset (Odds ratio 1.91, 95% confidence interval 1.07–3.39), contact with a COVID-19 positive case (OR 3.81, 95%CI 2.21–6.55) and anosmia (OR 7.80, 95%CI 4.20–14.49) as independent predictors of COVID-19, body ache (OR 6.17, 95%CI 2.69–14.14), headache (OR 5.03, 95%CI 1.88–13.44) and retro-orbital pain (OR 5.55, 95%CI 2.51–12.28) as independent predictors of dengue, while smoking was less likely observed with COVID-19 (OR 0.27, 95%CI 0.09–0.79) and upper respiratory tract infection symptoms were associated with OFIs. Conclusions/Significance Although prone to potential biases, these data suggest that non-severe dengue may be more symptomatic than COVID-19 in a co-epidemic setting with higher dengue attack rates. At clinical presentation, nine basic clinical and epidemiological indicators may help to distinguish COVID-19 or dengue from each other and other febrile illnesses.

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Section: Discussionsupporting

confidence: 88%

“…in a recent opinion paper, COVID-19 being more pronounced in the respiratory sphere [ 10 ]. Interestingly, we also found one COVID-19+ case who was tested negative for dengue suffering retro-orbital pain, as previously reported in Taiwan [ 13 ].…”

Section: Discussionsupporting

confidence: 86%

Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: A cohort study in a SARS-CoV-2 testing center on Reunion island

et al. 2021

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“… Retro-orbital pain Bilateral retro-orbital pain may be a prominent and even presenting symptom in patients with COVID-19 and can mimic conditions like dengue. [ 70 ] This case highlights the important fact that COVID-19 has features that are highly non-specific and can simulate a lot of other common conditions. Orbital cellulitis and sinusitis In the two cases reported by Turbin et al , two adolescent boys developed acute onset unilateral, progressive, painful orbital swelling.…”

Section: Orbital Manifestations Of Covid-19mentioning

confidence: 99%

“…Bilateral retro-orbital pain may be a prominent and even presenting symptom in patients with COVID-19 and can mimic conditions like dengue. [ 70 ] This case highlights the important fact that COVID-19 has features that are highly non-specific and can simulate a lot of other common conditions.…”

Section: Orbital Manifestations Of Covid-19mentioning

confidence: 99%

COVID-19 and Eye

Sen

Honavar

Sharma

et al. 2021

Indian Journal of Ophthalmology

259

141

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The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had health implications of unprecedented magnitude. The infection can range from asymptomatic, mild to life threatening respiratory distress. It can affect almost every organ of the body. Ophthalmologists world over are reporting various manifestations of the infection in the eye. This review was undertaken to help ophthalmologists recognize the possible manifestations and the stage of the viral disease when they commonly appear. Literature search was performed for the publications on ophthalmic manifestations of coronavirus disease-19 (COVID-19) between January 1, 2020 and January 31, 2021. 46 case reports, 8 case series, 11 cross sectional/cohort observational studies, 5 prospective interventional studies, 3 animal models/autopsy studies and 6 reviews/meta-analysis were included. Conjunctivitis is the most common manifestation and can develop at any stage of the disease. Direct effect due to virus, immune mediated tissue damage, activation of the coagulation cascade and prothrombotic state induced by the viral infection, the associated comorbidities and drugs used in the management are responsible for the findings in the eye. The viral ribonucleic acid (RNA) has been isolated from ocular tissues but the role of eye as a route for infection is yet to be substantiated. Ophthalmic manifestations may be the presenting feature of COVID-19 infection or they may develop several weeks after recovery. Ophthalmologists should be aware of the possible associations of ocular diseases with SARS-CoV-2 in order to ask relevant history, look for specific signs, advise appropriate tests and thereby mitigate the spread of infection as well as diagnose and initiate early treatment for life and vision threatening complications.

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“…3,8,9 Rarely, COVID-19 has been reported to produce an urticarial or erythematous rash or varicella-like lesions and so resembling other viral exanthematous illnesses including dengue. 2,8,[10][11][12][13][14][15][16] Whether these cases are truly suggestive of dengue-COVID-19 co-occurrences or merely examples of false-positive dengue serology tests remain to be determined. The rapid serological testing for dengue sometimes gives a false positive in acute undifferentiated febrile illness, and thus failure to consider COVID-19 in such cases has serious implications for the patient as well as public health.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and/with dengue infection: A curse in an overburdened healthcare system

Panda

Sharawat

2020

Trop Doct

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While the world battles to wrestle with the impact of the COVID-19 pandemic, regions with endemic dengue fever are confronting the possibility of a double pandemic that could completely overpower health care services administrations. Simultaneous outbreaks of dengue and COVID-19, as well as probable cases of overlapping infections, have already started in Latin America and certain Asian countries. There, the healthcare framework is already overburdened and such a deadly duo may completely overwhelm hospital emergency services quite apart from a country’s economy. Precise epidemiological and contact history-taking joined with due attention to false-positive dengue serology and the chance of co-infections are key devices for frontline doctors to overcome this seemingly insurmountable challenge.

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COVID-19 mimicking dengue fever with the initial manifestation of retro-orbital pain – A Rare Case

Cited by 15 publications

References 4 publications

Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: A cohort study in a SARS-CoV-2 testing center on Reunion island

Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: A cohort study in a SARS-CoV-2 testing center on Reunion island

COVID-19 and Eye

COVID-19 and/with dengue infection: A curse in an overburdened healthcare system

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