Dengue: Difference between revisions

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



Revision as of 23:31, 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 for pain/fever
      • DO NOT use ASA due to dz's hemorrhagic nature
  • IVFs
  • 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

See Also

Travel Medicine