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]


References

  1. 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.
  2. Ramos M, Abell A, Smith B (2006). "Dengue and South Texas: information for clinicians". Texas medicine 102 (8): 56–8. PMID 17115561[e]
  3. 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.
  4. 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.
  5. Alejandria M (2005). "Dengue fever". Clinical evidence (13): 887–95. PMID 16135283[e]