Dengue: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
*Clinical Diagnosis - High Fever + 'Breakbone' + GI sxs + Rash | |||
**Incubate for 4- 7d, influenza like prodrome, fvr, HA, myalgia, LN, rash | |||
*Labs: CBC: Leukopenia and thrombocytopenia | |||
**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 petechia per square inch | |||
Dengue shock syndrome and hem fvr rare in travelers- usually in pt c prev infc | |||
==Treatment== | ==Treatment== | ||
Revision as of 23:23, 12 January 2014
Background
- aedes mosquito in urban area
Diagnosis
- Clinical Diagnosis - High Fever + 'Breakbone' + GI sxs + Rash
- Incubate for 4- 7d, influenza like prodrome, fvr, HA, myalgia, LN, rash
- Labs: CBC: Leukopenia and thrombocytopenia
- 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 petechia per square inch
Dengue shock syndrome and hem fvr rare in travelers- usually in pt c prev infc
Treatment
- Supportive Care
- APAP
- DO NOT use ASA due to dz's hemorrhagic nature
- APAP
- IVF
- Blood Component Transfusion - consider in hemorrhagic shock
Dispo
- 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