Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- fiebre
- rubefacción o erupción en la piel
- mialgia, artralgia y cefalea
- signos hemorrágicos
- letargo o inquietud
- hepatomegalia
- distensión abdominal
- dolor torácico pleurítico, disnea, tos
- signos de colapso circulatorio
Other diagnostic factors
- síntomas gastrointestinales
- síntomas de las vías respiratorias altas
Risk factors
- residencia en zonas endémicas o viaje a una de esas zonas en el transcurso de las últimas 2 semanas
- niños de entre 1 y 5 años
- edad avanzada
- embarazo
- presencia de comorbilidades
- exposición a hemoderivados infectados
- vivir cerca de recipiente de agua destapado
- sexo femenino
- obesidad
- grupo sanguíneo O
Diagnostic tests
1st tests to order
- hemograma completo (HC)
- pruebas de función hepática (PFH)
- nivel de albúmina sérica
- serología
- reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR)
- detección de proteína no estructural 1 (NS1)
Tests to consider
- estudios de coagulación
- radiografía de tórax
- ultrasonido de abdomen
Emerging tests
- reacción en cadena de la polimerasa isotérmica aislada con transcripción inversa (RT-iiPCR)
Treatment algorithm
Grupo C de la OMS (signos de alarma establecidos)
Grupo B de la OMS (desarrollo de signos de alarma)
Grupo A de la OMS (sin signos de alarma)
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
Disclosures
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.
References
Key articles
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].Full text
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].Full text
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.Full text Abstract
Simmons CP, Farrar JJ, Nguyen VV, et al. Dengue. N Engl J Med. 2012;366:1423-1432. Abstract
Reference articles
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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