Management of Suspected Arboviral Illness

Initial Assessment and Management

The Centers for Disease Control and Prevention recommends managing patients with suspected arboviral illness, such as dengue fever, with hydration and supportive care, including antipyretics for fever control, while maintaining a high index of suspicion for mosquito-borne viral illness 1, 2
The presentation of high fever, sore throat, mild erythematous rash, and multiple mosquito bites with otherwise stable vitals suggests a mosquito-borne viral illness rather than bacterial infection requiring empiric antibiotics, according to the MMWR Recommendations and Reports 1, 2

Dengue fever is the most likely diagnosis given the constellation of fever, rash, and mosquito exposure, particularly if there is any travel history to endemic areas, as suggested by Praxis Medical Insights 2
The mild erythematous rash and sore throat are consistent with the febrile phase of dengue or other arboviral infections, according to the MMWR Recommendations and Reports 1

The American Academy of Pediatrics recommends administering acetaminophen or ibuprofen for fever control to improve patient comfort and reduce fever-related symptoms, with a strength of evidence rated as high 3, 1
The World Health Organization advises avoiding aspirin due to the risk of hemorrhagic complications if this is dengue or another viral hemorrhagic fever, with a strength of evidence rated as high 1
Oral or IV fluid resuscitation is the cornerstone of management for suspected arboviral illness, particularly dengue, as recommended by Praxis Medical Insights 2

The Centers for Disease Control and Prevention recommends complete blood count with differential to assess for thrombocytopenia, leukopenia, and hemoconcentration, with a strength of evidence rated as moderate 5, 2
Serial vital signs every 4-6 hours are necessary to detect early signs of hemodynamic instability, as suggested by Praxis Medical Insights 2

The American College of Emergency Physicians recommends admitting patients to the hospital if they develop signs of severe dehydration, altered mental status, severe bleeding, hypotension, or respiratory distress, with a strength of evidence rated as high 3, 4, 2
The Society of Critical Care Medicine suggests considering ICU admission if severe criteria develop, including parasitemia >5%, severe anemia, renal impairment, or metabolic acidosis, with a strength of evidence rated as moderate 5