UMEM Educational Pearls

Category: International EM

Title: Criteria for Dengue Hemorrhagic Fever

Keywords: Dengue, Hemorrhagic Fever, arbovirus, flavivirus (PubMed Search)

Posted: 2/18/2016 by Jon Mark Hirshon, PhD, MPH, MD
Click here to contact Jon Mark Hirshon, PhD, MPH, MD

What are the criteria for dengue hemorrhagic fever?

  • Fever lasting 2-7 days
    • May be biphasic

  • Hemorrhagic tendencies
    • Positive tourniquet (aka Rumpel-Leede) test
    • Petechiae, ecchymosis or purpura
    • GI bleeding

  • Thrombocytopenia (<100,000/mm3)

  • Evidence of plasma leakage
    • Increase in hematocrit >20% above age/sex normal
    • Decrease in hematocrit >20% after volume replacement
    • Signs of plasma leakage
      • e.g. pleural effusions, ascites, hypoproteinemia