Dengue fever: Difference between revisions
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'''Dengue fever''' is a viral disease transmitted by mosquitoes and is endemic in tropical and subtropical regions.<ref>{{cite web |url=http://www.searo.who.int/en/Section10/Section332_12647.htm |title=Dengue Fever - Information Sheet |accessdate=2007-10-09 |format= |work=}}</ref><ref name="pmid16135837">{{cite journal |author=Wilder-Smith A, Schwartz E |title=Dengue in travelers |journal=N. Engl. J. Med. |volume=353 |issue=9 |pages=924–32 |year=2005 |pmid=16135837 |doi=10.1056/NEJMra041927}}</ref> Because of the severe myalgias and arthralgias, it has been called "breakbone fever". | '''Dengue fever''' is a viral disease transmitted by mosquitoes and is endemic in tropical and subtropical regions.<ref>{{cite web |url=http://www.searo.who.int/en/Section10/Section332_12647.htm |title=Dengue Fever - Information Sheet |accessdate=2007-10-09 |format= |work=}}</ref><ref name="pmid16135837">{{cite journal |author=Wilder-Smith A, Schwartz E |title=Dengue in travelers |journal=N. Engl. J. Med. |volume=353 |issue=9 |pages=924–32 |year=2005 |pmid=16135837 |doi=10.1056/NEJMra041927}}</ref> Because of the severe [[myalgias|myalgia]] and [[arthralgias|arthalgia]], it has been called "breakbone fever". Dengue fever is most prevalent in southeast Asia, but also occurs in Africa, Europe, South America, and southern regions of North America (South Texas).<ref name="pmid17115561">{{cite journal |author=Ramos M, Abell A, Smith B |title=Dengue and South Texas: information for clinicians |journal=Texas medicine |volume=102 |issue=8 |pages=56–8 |year=2006 |pmid=17115561 |doi=}}</ref> It may also occur in non-endemic regions in travelers from endemic regions.<ref name="pmid16135837">{{cite journal |author=Wilder-Smith A, Schwartz E |title=Dengue in travelers |journal=N. Engl. J. Med. |volume=353 |issue=9 |pages=924–32 |year=2005 |pmid=16135837 |doi=10.1056/NEJMra041927}}</ref> | ||
==Classification== | ==Classification== | ||
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* '''Undifferentiated fever''' (viral syndrome) | * '''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 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 100x10<sup>9</sup>/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 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 100x10<sup>9</sup>/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. | * '''[[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== | ==Treatment== | ||
* Intravenous fluids. Crystalloid solutions such as Ringer's lactate may be better than colloid solutions.<ref name="pmid16135832">{{cite journal |author=Wills BA, Nguyen MD, Ha TL, ''et al'' |title=Comparison of three fluid solutions for resuscitation in dengue shock syndrome |journal=N. Engl. J. Med. |volume=353 |issue=9 |pages=877–89 |year=2005 |pmid=16135832 |doi=10.1056/NEJMoa044057}}</ref> | * Intravenous fluids. Crystalloid solutions such as [[Ringer's lactate]] may be better than colloid solutions.<ref name="pmid16135832">{{cite journal |author=Wills BA, Nguyen MD, Ha TL, ''et al'' |title=Comparison of three fluid solutions for resuscitation in dengue shock syndrome |journal=N. Engl. J. Med. |volume=353 |issue=9 |pages=877–89 |year=2005 |pmid=16135832 |doi=10.1056/NEJMoa044057}}</ref> | ||
* [[Glucocorticoids]] are of uncertain benefit.<ref name="pmid16135283">{{cite journal |author=Alejandria M |title=Dengue fever |journal=Clinical evidence |volume= |issue=13 |pages=887–95 |year=2005 |pmid=16135283 |doi=|url=http://clinicalevidence.bmj.com/ceweb/conditions/ind/0917/0917.jsp}}</ref> | * [[Glucocorticoids]] are of uncertain benefit.<ref name="pmid16135283">{{cite journal |author=Alejandria M |title=Dengue fever |journal=Clinical evidence |volume= |issue=13 |pages=887–95 |year=2005 |pmid=16135283 |doi=|url=http://clinicalevidence.bmj.com/ceweb/conditions/ind/0917/0917.jsp}}</ref> | ||
== Causitive agent == | |||
Dengue fever is caused by infection of one of the four Dengue fever viruses. The Dengue fever viruses are classified as [[flaviviruses]] (family Flavividae, genus Dengue). | |||
==References== | ==References== | ||
Revision as of 08:43, 9 October 2007
Dengue fever is a viral disease transmitted by mosquitoes and is endemic in tropical and subtropical regions.[1][2] Because of the severe myalgia and arthalgia, it has been called "breakbone fever". Dengue fever is most prevalent in southeast Asia, but also occurs in Africa, Europe, South America, and southern regions of North America (South Texas).[3] It may also occur in non-endemic regions in travelers from endemic regions.[2]
Classification
The World Health Organization has classified Dengue fever as:[4]
- 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.[5]
- Glucocorticoids are of uncertain benefit.[6]
Causitive agent
Dengue fever is caused by infection of one of the four Dengue fever viruses. The Dengue fever viruses are classified as flaviviruses (family Flavividae, genus Dengue).
References
- ↑ Dengue Fever - Information Sheet. Retrieved on 2007-10-09.
- ↑ 2.0 2.1 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]