Generalized body aches, high grade fever followed by clinical deterioration and bleeding diathesis with raised hematocrit (65%) and low platelet and leucopenia strongly suggest dengue haemorrhagic fever, although meningococcemia is always a close diagnosis and many times requires serological confirmation. Complicated malaria usually has anemia and splenomegaly Leptospirosis may occur in icteric as well as nonicteric form. In nonicteric form shock and skin rashes are uncommon. Prominent features are severe myalgias and exquisite tenderness.