Dengue Fever Diagnosis, Dengue Diagnosis

Dengue Diagnosis

Since late 2008 changed the definition of dengue, because the former WHO classification was very rigid and the criteria used for case definition of dengue hemorrhagic fever requiring the performance of laboratory tests that were not available in all places. For this reason up to 40% of the cases was not possible to apply the proposed classification. Additionally between 15 and 22% of patients with dengue shock did not meet the criteria for the guide, which were not given timely treatment. After several efforts by groups of experts in Asia and America, several studies such as the Dengue Control (DENCO) changed the classification for dengue and severe dengue. This classification is more dynamic and wide, allowing a more holistic approach to disease.

The disease (which one) has two styles: dengue and severe dengue. After an incubation period of 2 to 8 days, which may seem like a box without catarrhal fever, typically expressed with the above symptoms. Up to 80% of cases the disease can be asymptomatic or mild, even going unnoticed. The natural history of the disease typically describes three clinical phases: A febrile phase, which lasts from 2 to 7 days, a critical phase, which shows the warning signs of the disease (abdominal pain, vomiting, mucosal bleeding, abnormal the state of consciousness), thrombocytopenia, the manifestations of organ damage (liver, myocarditis, encephalopathy, etc.), plasma extravasation shock or severe bleeding (usually associated with digestive tract bleeding). Finally, this recovery phase, in which there is a rise in platelet count and lymphocytes, hemodynamic stabilization, among others.

The definition of probable case of dengue A fever of up to 7 days, no apparent source, associated with the presence of two or more of the following:

Headache
Pain retrocular
Myalgia
Arthralgia
Prostration
Exanthema
It may or may not be accompanied by bleeding
History of displacement (up to 15 days before the onset of symptoms) or who resides in a dengue endemic area.

The definition of severe dengue:

Plasma leakage leading to:

Shock or fluid accumulation (edema) with respiratory distress.

Severe bleeding
Severe organ involvement (liver, heart, brain)

Laboratory diagnosis can be performed by various forms, which are grouped into direct and indirect methods.

Among the direct methods are:

Virus Isolation: We performed a test in the serum during the first 72 hours.

RCP: nucleic acid detection

NS1: Detection of a viral envelope protein

Indirect methods:

IgM dengue antibody detection in blood. Blood is made after the fifth day of illness.

Other laboratory findings may include:

Leucopenia
Thrombocytopenia
Hypoalbuminemia
Hemoconcentration with increased hematocrit

This latter finding is secondary to plasma leakage experienced by patients, which also can be found ascites and pleural effusion.

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