Dengue

• Dengue a common viral hemorrhagic fever
• Dengue

  Causative Agent: Dengue Virus 1,2,3,4 (Can only be infected once by EACH strain)
• Dengue

  Mode of Transmission: Aedes Aegypti (Vector)
• Dengue (Grading)

  Grade I - (-) shock, (+) torniquet test, mild symptoms (butlig at lagnat)

  Grade II - (-) shock, (+) spontaneous bleeding, (+) torniquet test

  Grade III - (+) shock, plasma leakage, low BP (hypo,tachy,tachy)

  Grade IV - profound shock, unmeasurable bleeding (no BP/pulse)
• Dengue Diagnostics

  Rumpel Lead Test (Tourniquet Test)

  • Screening test for dengue
  • presumptive
• Biphasic / Saddleback - high fever for 2-4 days then return to normal for 1-2 days then increase again 
• Dengue Diagnostics: Tourniquet/Rumpel Lead Test

  After 5 minutes of test

  • Positive - >20 petechiae
  • Negative - <20 petechiae
• Dengue Diagnostics

  CBC: High Hct, Low Platelet - does NOT confirm dengue
• Dengue Diagnostics

  Serological Test - ELISA / EIA(+) Antibodies - confirmatory test
• Dengue Management

  Fluid Replacement - Most important treatment

  • Conscious: ORS
  • Bleeding: IVF (Plain LR - preferred), then colloids (plasma expander)
  • Decreasing hematocrit - indication that the patient is improving
• Dengue Management

  • R - Rest
  • A - Antipyretic - DOC: Paracetamol; C/I: Aspirin, NSAIDS 
  • I - Ice Pack
  • D - Diet: NO dark-colored foods/fluids