Dengue and relative bradycardia.

To the Editor: In a recent letter to Emerging Infectious Diseases, Lateef and colleagues identified a relationship between dengue and relative bradycardia in patients in Singapore. They stated that "To our knowledge, this sign has not been previously associated with dengue" (1). Unfortunately, the association of dengue fever with relative bradycardia has already been well established and is certainly not a new finding (2,3). Despite this, however, there is no harm done in reinforcing an often forgotten clinical sign that can assist in the diagnosis of dengue, especially in those countries with limited resources.

References

(1.) Lateef A, Fisher DA, Tambyah PA. Dengue and relative bradycardia. Emerg Infect Dis. 2007;13:650.

(2.) Senanayake S. Dengue fever and dengue haemorrhagic fever--a diagnostic challenge. Aust Fam Physician. 2006;35: 609-12.

(3.) Wittesjo B, Bjornham A, Eitrem R. Relative bradycardia in infectious diseases. J Infect. 1999;39:246-7.

Address for correspondence: Sanjaya Naresh Senanayake, The Canberra Hospital--Infectious Diseases, Level 4, Bldg 10, PO Box 11, Woden, ACT 2606, Australia; email: [e-mail]

Sanjaya Naresh Senanayake *

* The Canberra Hospital--Infectious Diseases, Woden, Australian Capital Territory, Australia