Dengue: Difference between revisions

Revision as of 20:58, 17 February 2015

Aedes mosquito in urban area, especially during rainy seasons in tropical/subtropic regions (Asia, Africa, Central America, Caribbean)
- Most cases occur in SE Asia
Dengue shock syndrome and hem fever rare in travelers
- Caused by second infection of different Dengue serotype

Clinical Diagnosis - High Fever + 'Breakbone' + GI sxs + Rash + possible exposure
- Incubate for 4- 7d, influenza like prodrome, fvr, HA, myalgia, LN, rash
- "Saddle back" fever
  - high for several days, resolves for several days, then comes back for several days
Labs:
- CBC: Leukopenia, thrombocytopenia, and hemoconcentration
- CMP: LFTs elevated
- DIC labs should be sent
- Dx by 4x increase in acute/ conv titres - unlikely to be resulted in ED
Tourniquet Test - Tests capillary fragility
- Inflate cuff to pressure b/w SBP & DBP, and leave for 5 min
- (+) Test = 10-20 patechiae per square inch

Supportive Care
- APAP for pain/fever
  - DO NOT use ASA due to dz's hemorrhagic nature
IVFs
Blood Component Transfusion - consider in hemorrhagic shock

Home - Well hydrated and non-toxic appearing
Admit - High-risk pts (ie pregnant, elderly, children, chronic dz)
- ICU - pts with shock and end-organ damage

@@ Line 10: / Line 10: @@
 **"Saddle back" fever
 ***high for several days, resolves for several days, then comes back for several days
-*Labs: CBC: Leukopenia and thrombocytopenia
+*Labs:
+** CBC: Leukopenia, thrombocytopenia, and hemoconcentration
 **CMP: LFTs elevated
 **[[DIC]] labs should be sent