Dengue: Difference between revisions
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*Tourniquet Test - Tests capillary fragility | *Tourniquet Test - Tests capillary fragility | ||
**Inflate cuff to pressure b/w SBP & DBP, and leave for 5 min | **Inflate cuff to pressure b/w SBP & DBP, and leave for 5 min | ||
**(+) Test = 10-20 | **(+) Test = 10-20 patechiae per square inch | ||
Dengue shock syndrome and hem fvr rare in travelers- usually in pt c prev infc | Dengue shock syndrome and hem fvr rare in travelers- usually in pt c prev infc | ||
Revision as of 23:30, 12 January 2014
Background
- Aedes mosquito in urban area, especially during rainy seasons in tropical/subtropic regions (Asia, Africa, Central America, Caribbean)
- Most cases occur in SE Asia
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 patechiae 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