Dengue Shock syndrome

Yes, today we had a case with dengue shock syndrome.I clerked and presented the case to one of the specialist.This patient had interesting signs.He had petechial rash(non-blanching), "white islets in the sea of red".On PE, the air entry to the lung is decreased bilaterally,the lung was stony dull to percussion bilaterrally at the middle and lower zone of the lung.Breath sound is not heard bilaterally at the lower zone.This patient was having pleural effusion.He also had ascites.Shifting dullness was positive.Will be doing PE again tomorrow morning before all the signs disappear! :p