Summary
Definition
History and exam
Key diagnostic factors
- fever
- skin flushing/rash
- myalgia/arthralgia/headache
- hemorrhagic signs
- lethargy/restlessness
- hepatomegaly
- abdominal distention
- pleuritic chest pain, dyspnea, cough
- signs of circulatory collapse
Other diagnostic factors
- gastrointestinal symptoms
- upper respiratory tract symptoms
Risk factors
- residence in/travel from dengue-endemic region within the past 2 weeks
- children ages 1 to 5 years
- older age
- pregnancy
- presence of comorbidities
- exposure to infected blood products
- living with uncovered water container
- female sex
- obesity
- blood group O
Diagnostic tests
1st tests to order
- CBC
- liver function tests (LFTs)
- serum albumin level
- serology
- reverse transcription-polymerase chain reaction (RT-PCR)
- nonstructural protein 1 (NS1) detection
Tests to consider
- coagulation studies
- chest x-ray
- abdominal ultrasound
Emerging tests
- reverse transcription-insulated isothermal polymerase chain reaction (RT-iiPCR)
Treatment algorithm
WHO group C (established warning signs)
WHO group B (developing warning signs)
WHO group A (no warning signs)
Contributors
Authors
S.A.M. Kularatne, MBBS, MD, MRCP (UK), FRCP (London), FCCP (SL)
Senior Professor
Chair of Medicine
Department of Medicine
Faculty of Medicine
University of Peradeniya
Peradeniya
Sri Lanka
Disclosures
SAMK is an author of several references cited in this topic.
Peer reviewers
John McBride, PhD, MBBS, DTM&H, FRACP, FRCPA
Professor of Medicine
James Cook University
Cairns Base Hospital Clinical School
Cairns
Australia
Disclosures
JM declares that he has no competing interests.
Michael Jacobs, MA, PhD, MBBS, FRCP, DTM&H
Consultant
Infectious Diseases
Royal Free Hampstead NHS Trust
London
UK
Disclosures
MJ declares that he has no competing interests.
Stephen Gluckman, MD
Professor of Medicine
Medical Director
Penn Global Medicine
Penn Center for Primary Care
PA
利益声明
SG declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
World Health Organization, Regional Office for South-East Asia. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever - revised and expanded edition. 2011 [internet publication].全文
World Health Organization, Special Programme for Research and Training in Tropical Diseases (TDR). Dengue: guidelines for diagnosis, treatment, prevention and control. New edition. 2009 [internet publication].全文
Guo C, Zhou Z, Wen Z, et al. Global epidemiology of dengue outbreaks in 1990-2015: a systematic review and meta-analysis. Front Cell Infect Microbiol. 2017 Jul 12;7:317.全文 摘要
Simmons CP, Farrar JJ, Nguyen VV, et al. Dengue. N Engl J Med. 2012;366:1423-1432. 摘要
Centers for Disease Control and Prevention. Dengue: treatment. May 2019 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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