An Emergency Diagnostic Tool Mechanism Formation Of More Than 20 Petechiae Per Square Inch Indicates A Positive Test

1168 Words Mar 30th, 2015 5 Pages
Laboratory Diagnosis
Monitoring Parameters
• Tourniquet Test
Acts as an emergency diagnostic tool whereby formation of more than 20 petechiae per square inch indicates a positive tourniquet test. A circle of 2.5 cm in diameter may be drawn and the number of petechiae in it is counted. More than five petechiae indicates positive test.
• Complete Blood Cell Count
Blood tests present with lowered total white blood cell, platelet and neutrophil counts and a 20% or more increase in haematocrit values suggests haemoconcentration. Thus, monitoring should be done every 3-4 hours in cases of severe dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Thrombocytopenia is observed with platelet count of lesser than 100,000 cells/μL. Thus, monitoring should be done at least every 24 hours for early detection of DHF.
• Metabolic Panel and Liver Enzymes
Hyponatremia will be presented. Patients with shock will have blood urea nitrogen (BUN) levels that are elevated and metabolic acidosis.
DHF patients may have elevated aspartate aminotransferase, creatine kinase and lactate dehydrogenase and lowered levels of triglycerides, albumin and total cholesterol.
• Coagulation Studies
Prolonged prothrombin time and activated partial prothromboplastin time. Fibrinogen is reduced and elevated levels of fibrin degradation product.
• Ultrasonography
Pleural effusion, peritoneal effusion and thickened gallbladder wall seen in ultrasonographic findings. Diagnostic Tests
• Molecular
 Virus…

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