Syndromic Approach to Diagnosis of Viral Thrombocytopenic Fever
Journal Title: International Journal of Contemporary Medical Research - Year 2016, Vol 3, Issue 1
Abstract
Introduction: Acute febrile illness with thrombocytopenia is quite common in the tropics. Most of them have a benign course with nonspecific symptoms. Dengue polymerase chain reaction (PCR) and viral cultures are expensive, time consuming and not feasible in all cases, especially in resource limited settings. Hence, in this study we have compared the clinical diagnosis of dengue illness according to CDC 2009 guidelines syndromic approach along with serological tests used routinely in the diagnosis of dengue. Materials and methods: A total of 100 patients, admitted to our hospital during June 2015 to August 2015, with history of fever (>98.8 F), body ache and thrombocytopenia (platelets<1.5 lakhs/cumm), were enrolled in the study. A careful history was taken followed by relevant systematic examinations. The patients who were tested positive for malarial parasite, chikungunya, leptospira or hanta virus, were excluded. After excluding other causes of fever and thrombocytopenia, 83 patients were classified according to CDC 2009 definition of dengue. Results: We found that NS-1 and IgM were positive in 40% and 6.8% of the cases respectively in patients having dengue without warning signs in whom the mean duration of illness was 3 days. The same tests were found positive in 35.5 % and 38.4% respectively in the category of patients who had warning signs where mean duration of illness was 6.5 days. Conclusion: We concluded that the milder varieties of dengue illness should be managed according to CDC 2009 guidelines with a syndromic approach, after ruling out diseases with specific treatments such as malarial, leptospiral and ricketsial infections.
Authors and Affiliations
Ashwin Kulkarni, Anil Kumar. T, Lakshmi Narayan A
Keywords
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