{"id":10280,"date":"2024-01-31T19:56:10","date_gmt":"2024-01-31T19:56:10","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=10280"},"modified":"2025-12-30T18:57:30","modified_gmt":"2025-12-30T18:57:30","slug":"dengue-hemorrhagic-fever-and-shock","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/dengue-hemorrhagic-fever-and-shock\/","title":{"rendered":"Diagnostic Criteria for Dengue Hemorrhagic Fever (DHS) and Dengue Shock Syndrome (DSS)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Dengue hemorrhagic fever is an immunopathologic disease; dengue virus\u2013antibody immune complexes trigger release of vasoactive mediators by macrophages. The mediators increase vascular permeability, causing vascular leakage, hemorrhagic manifestations, hemoconcentration, and serous effusions, which can lead to circulatory collapse (ie, dengue shock syndrome).<!--more--><\/p>\n<p><strong>Diagnostic Criteria for Dengue Hemorrhagic Fever (DHS) and Dengue Shock Syndrome (DSS)<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr style=\"height: 26px;\">\n<td style=\"width: 100%; height: 26px;\" colspan=\"2\"><strong>Dengue Hemorrhagic Fever<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 31.1125%; height: 24px;\" colspan=\"2\">Presence of all of the following:<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 31.1125%; height: 24px;\">Fever<\/td>\n<td style=\"width: 68.8875%; height: 24px;\">Acute onset of 2-7 days<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 31.1125%; height: 24px;\">Haemorrhagic manifestations<\/td>\n<td style=\"width: 68.8875%; height: 24px;\">Evidenced by positive tourniquet test, petechiae,\u00a0ecchymoses or purpura, or bleeding from mucosa,\u00a0gastrointestinal tract, injection sites, or other\u00a0locations.<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 31.1125%; height: 24px;\">Thrombocytopenia<\/td>\n<td style=\"width: 68.8875%; height: 24px;\">Platelet count of \u2264100 000 cells\/mm3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 100%; height: 24px;\" colspan=\"2\"><strong>Dengue Shock Syndrome (DSS)<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 31.1125%; height: 24px;\" rowspan=\"3\">Criteria for DHS (As above) and\u00a0signs of shock<\/td>\n<td style=\"width: 68.8875%; height: 24px;\">Tachycardia, cool extremities, delayed capillary\u00a0refill, weak pulse, lethargy or restlessness (a sign of\u00a0reduced brain perfusion).<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 68.8875%; height: 24px;\">Pulse pressure \u226420 mmHg with increased diastolic\u00a0pressure, e.g. 100\/80 mmHg.<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 68.8875%; height: 24px;\">Hypotension by age, defined as systolic pressure &lt;80\u00a0mmHg for those aged &lt;5 years or 80 to 90 mmHg for older children and adults.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The first two clinical criteria, plus thrombocytopenia and haemoconcentration or a rising haematocrit, are sufficient to establish a clinical diagnosis of DHF. The presence of liver enlargement in addition to the first two clinical criteria is suggestive of DHF before the onset of plasma leakage. In cases with shock, a high haematocrit and marked thrombocytopenia support the diagnosis of DSS. A low ESR (&lt;10 mm\/first hour) during shock differentiates DSS from septic shock.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Paz-Bailey G, Adams LE, Deen J, Anderson KB, Katzelnick LC. Dengue. Lancet. 2024 Jan 24:S0140-6736(23)02576-X. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38280388\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Tejo AM, Hamasaki DT, Menezes LM, Ho YL. Severe dengue in the intensive care unit. J Intensive Med. 2023 Sep 28;4(1):16-33. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38263966\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Singh RK, Tiwari A, Satone PD, Priya T, Meshram RJ. Updates in the Management of Dengue Shock Syndrome: A Comprehensive Review. Cureus. 2023 Oct 9;15(10):e46713. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38021722\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control: New Edition. Geneva: World Health Organization; 2009. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23762963\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Jan 24, 2024.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"footnotes":""},"categories":[39],"tags":[16,15,680,14,13,802,2644,2643,614,5,4],"class_list":["post-10280","post","type-post","status-publish","format-standard","hentry","category-infetious-disease","tag-criteria","tag-criterios","tag-dengue","tag-diagnostic","tag-diagnostico","tag-fever","tag-hemorragico","tag-hemorrhagic","tag-shock","tag-sindrome","tag-syndrome"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - 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