Saturday, December 6, 2014

Dengue fever, DHF, DSS and WHO criteria mnemonic

WHO criteria for diagnosis of dengue fever
All three of these should be present:
1. Fever
2. Two or more of the following clinical symptoms (See below, HARM mnemonic)
3. Positive serology or occurrence with same time and place as other confirmed cases of dengue.

The mnemonic for symptoms is, "HARMS" -
Hemolytic tendencies (Ecchymoses, purpura)
Retro orbital pain
S part is for labs, I clubbed it together for completion -
Serology for dengue +ve
Short of WBC's (Leucopenia)

WHO criteria for diagnosis of dengue hemorrhagic fever
All 4 of these should be present to diagnose DHF:
Mnemonic is, "The leaky hemorrhagic fever."
1. Thrombocytopenia
(Platelets < 100,000/cu mm)
2. Evidence of plasma leakage
(> 20% rise in hematocrit
>20% drop following fluids
Signs like pleural effusion, ascites, hypoproteinaema)
3. Signs of hemorrhagic tendencies (Positive tourniquet test
Petechiae, ecchymoses, purpura
Bleeding from gums
Haematemesis, melaena)
4. Fever (Lasting for 2-7 days)

WHO criteria for dengue shock syndrome
All 4 for DHF + signs of circulatory failure.
The mnemonic is, "CHIRP" -
C: Cold clammy skin
H: Hypotension
R: Restlessness
Rapid and weak pulse
P: Narrow pulse pressure

That's all! *phew*

There's another "ALL LOVE" mnemonic on the internet for warning signs of dengue. You should check that out too!



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