Dengue fever
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Dengue fever is a viral disease transmitted by mosquitoes and is endemic in tropical and subtropical regions.[1] Because of the severe myalgias and arthralgias, it has been called "breakbone fever". Its distribution includes South Texas.[2] It may also occur in non-endemic regions in travelers from endemic regions.[1]
Classification
The World Health Organization has classified Dengue fever as:[3]
- Undifferentiated fever (viral syndrome)
- Dengue fever syndrome has at least two of: 1) headache; 2)retro-orbital pain; 3) myalgia, 4) arthralgia; 4) rash; 5) hemorrhagic manifestations; 6) leucopenia. There must be other confirmed cases of dengue fever in the geographic area.
- Dengue hemorrhagic fever (plasma leakage) must meet four of the following criteria: 1) fever or history of fever lasting 2–7 days; 2) positive tourniquet test or spontaneous bleeding; 3) platelet count 100x109/L or less; 4) plasma leakage shown either by hemoconcentration with changes in packed-cell volume, or by the development of pleural effusions or ascites.
- Dengue shock syndrome is Dengue hemorrhagic fever with shock. Grade III is narrowing of the pulse pressure or hypotension for age; Grade IV is no detectable pulse or blood pressure.
Treatment
- Intravenous fluids. Crystalloid solutions such as Ringer's lactate may be better than colloid solutions.[4]
- Glucocorticoids are of uncertain benefit.[5]
References
- ↑ 1.0 1.1 Wilder-Smith A, Schwartz E (2005). "Dengue in travelers". N. Engl. J. Med. 353 (9): 924–32. DOI:10.1056/NEJMra041927. PMID 16135837. Research Blogging.
- ↑ Ramos M, Abell A, Smith B (2006). "Dengue and South Texas: information for clinicians". Texas medicine 102 (8): 56–8. PMID 17115561. [e]
- ↑ Deen JL, Harris E, Wills B, et al (2006). "The WHO dengue classification and case definitions: time for a reassessment". Lancet 368 (9530): 170–3. DOI:10.1016/S0140-6736(06)69006-5. PMID 16829301. Research Blogging.
- ↑ Wills BA, Nguyen MD, Ha TL, et al (2005). "Comparison of three fluid solutions for resuscitation in dengue shock syndrome". N. Engl. J. Med. 353 (9): 877–89. DOI:10.1056/NEJMoa044057. PMID 16135832. Research Blogging.
- ↑ Alejandria M (2005). "Dengue fever". Clinical evidence (13): 887–95. PMID 16135283. [e]