atypical dengue

 When I was hospitalized with dengue, I did not have any headache or muscle pain (except for my normal aches and pain).

What happened is that I went to the bathroom and fell and literally couldn't get up. No it was worse than that: I could barely move to put my hands out to have the family get me up. And I could not turn over or try to get on my knees. The weakness was generalized, not a local paralysis, and the weakness was partial: i could move a little but I was weak. 

Reminds me of the commercial of the little old lady pushing her panic button saying I'm weak and I can't get up.

I figured it was hypokalemia, and after 15 minutes I told the family to call an ambulance to get me to the hospital. I remember sitting in the outside ER waiting for my test for covid to come back, and I remember thinking: Please start an IV with potassium in it so I don't feel weak. But actually my potassium (and covid) were normal, so I was admitted on IVs.

I literally don't remember what time this happened, or why the family was with me (early evening) and I think I was running a low fever because I thought I had a UTI since I had no other symptoms.

But essentially I don't remember that day, and much of the time in the hospital I don't remember much, except Joy sitting with me texting and talking on her phone, and being encouraged to drink fluids. I remember having blood drawn a lot, but I don't remember having a physical examination done on me, nor getting a chest x ray, nor having my clothes removed and being put into a hospital gown. after two or three days I could sit up and by the time I went home I could walk a bit but got a portable potty because I douln't make it to the bathroom.

The main treatment of dengue is fluis, and of course in the hospital I had a catheter

I remember being pushed to drink fluids, but don't remember eating until the third day ? the maid Lila encouraged me to eat rice and chicken, at which point I vomited and defacated two weeks of hard BM a few minutes later.

and the next few days I got my strength back and was able to sit up. But although my memory was spotty, I could think: and I could interpret my blood tests shown to me. By day three, my IGM test came back positive for Dengue, which is going around, so that was my diagnosis.

and as I improved, I remember being shown my blood tests, and as I got stronger I could watch my platelets go down down down... but never below 60thousand so no problem. And of course my WBC was low. No cough, no pain.

Well anyway, all of this puzzled me: Dengue is called break bone fever and the headache behind the eyes is the way you diagnose it clinically. But I had no pain and no headache. 

Two articles discussing dengue with these problems, but alas the articles are behind a pay wall:

Acute pure motor quadriplegia: is it dengue myositis?

Seven out of 16 patients with dengue infection presented with quadriplegia and they were subjected to a detailed clinical history and examination. Diagnosis of dengue was based on characteristic clinical and positive serum IgM ELISA. Blood counts, serum chemistry, CSF analysis and nerve conduction and electromyographic (EMG) studies were performed in all. Outcome was defined at the end of 1 month into complete, partial and poor on the basis of activities of daily living

,,,Weakness developed within 3-5 days of illness, which was severe in 4 and moderate in 3 patients. Hypotonia and hyporeflexia were present in 5 patients. Nerve conduction and EMG studies were normal in all except one whose EMG was myopathic. Serum CPK and SGPT were raised in all and serum bilirubin in 3 patients. All the patients had coagulopathy and 6 had thrombocytopenia. Muscle biopsy in 1 patient was suggestive of myositis. Six patients improved completely and one had poor recovery who needed ventilatory support.

Conclusion: Dengue virus infection may result in acute pure motor quadriplegia due to myositis. In an endemic area it should be considered in the differential diagnosis of acute flaccid paralysis.

a longer article is here:Neurological manifestations of dengue virus infection

much of the article is about encephalopathy

In the pure motor weakness group, CK was elevated in 5 and EMG and muscle biopsy were consistent with myositis in 1 patient each. The patients with pure motor weakness improved completely...

so apparently it does happen

and I did recover, although weakness remained (more like easy fatigue with exercize: I could barely walk the dogs or attend church) and then when I was getting better, I developed shingles: neuropathic pain along a single nerve of my chest, but no rash.

The doc said it was costochondritis but this pain was different, and responded nicely to Lyrica, which is a medicine for neuropathic pain.