Dengue Oh Dengue...

• Dengue is a dynamic disease and presented in three phases - febrile phase, critical phase and recovery phase.
• Clinical deterioration often occurs in the critical phase and is marked by plasma leakage and rising haemotocrit (HCT).
• Look out for warning signs which may indicate severe dengue or high possibility of rapid progression or shock.
• Recognition of shock in its early stage and prompt fluid resuscitation with close monitoring of fluid adjustment will give a good clinical outcome.
• There is no evidence to support prophylactic use of platelet transfusion.

WARNING SIGNS FOR DENGUE

Warning signs (either one) indicate referral for admission eventhough platelet is normal

• Abdominal pain or tenderness
• Persistent vomiting
• Clinical fluid accumulation (pleural effusion/ascites)
• Mucosal bleed
• Restlessness or lethargy
• Liver enlargement >2 cm
• Laboratory : Increase in HCT concurrent with rapid decrease in platelet

You can download the electronic version for Malaysia CPG Guideline for Dengue 2010 2nd edition http://www.moh.gov.my/
or http://www.acadmed.org.my/