Coxsackie virus vs Dengue, clinical case: Differential diagnosis in syndemic

In tropical regions, the simultaneous presence of multiple infectious agents complicates diagnosis and treatment. This clinical case describes a 4-year-old boy presenting with fever, malaise, and pruritic rashes on the palms and soles, initially suspected as dengue. Laboratory results showed normal platelet and hematocrit levels, excluding dengue fever. The dermatological pattern and self-limiting course were consistent with hand-foot-and-mouth disease caused by Coxsackievirus A. Differential diagnosis between Coxsackievirus and dengue is crucial in endemic settings due to overlapping symptoms such as fever and rash. Recognition of specific dermatological manifestations—particularly vesicular or pruritic lesions on acral regions—and the absence of thrombocytopenia are key diagnostic clues. The case emphasizes the importance of clinical vigilance and basic laboratory testing to distinguish between similar viral syndromes, thereby avoiding unnecessary interventions and ensuring appropriate management in pediatric populations from dengue-endemic areas.