- 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