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December 4, 1943


JAMA. 1943;123(14):927. doi:10.1001/jama.1943.02840490055024

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To the Editor:—  In The Journal, June 5, appeared an article entitled "Pretibial Fever, An Obscure Disease," by Lieut. Col. Worth B. Daniels and Capt. H. Arthur Grennan. In this article a case is made for a new syndrome characterized by fever and headache of the orbital type initiated by chills or chilly sensations and further characterized by the appearance shortly after the onset by splotchy erythematous coalescing lesions involving the anterior surface of both legs predominantly. In my experience with several hundreds of cases of dengue in an area where dengue is hyperendemic, the clinical manifestations of the disease were no different from those described in the article mentioned with the exception of the predominance of pretibial lesions. Such pretibial lesions, however, were not uncommon in this series, although they were generally associated with similar lesions on the trunk. In an article written by Rice (Am. J. Trop. Dis.

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