This slide illustrates the signs and symptoms of dengue hemorrhagic fever in 57 hospitalized patients in Puerto Rico. These patients ranged in age from 4 to 86 years, with a mean age of 38 years, and all were laboratory diagnosed. While the specific manifestations seen in each dengue outbreak may differ slightly, these results are generally applicable to what has been seen in other parts of the world as well. All 57 cases had laboratory confirmation of dengue diagnosis and all met the four criteria for DHF.

• All had fever—as it is part of the case definition for DHF.
• 47% had rash noted in the hospital record.
• 11% had hepatomegaly.
• 5% had some type of effusion.
• Three patients, or 5% of the group, had shock and the two fatalities in this group both had shock.
• All patients had some type of hemorrhagic manifestation—again, that is part of the case definition.