Diagnosis

1.Tourniquet Test

  • Inflate blood pressure cuff to a point midway between systolic and diastolic pressure for 5 minutes
  • Positive test: 20 or more petechiae per 1 inch² (6.25 cm²)

Source: Pan American Health Organization: Dengue and Dengue Hemorrhagic Fever: Guidelines for Prevention and Control. PAHO: Washington, D.C., 1994: 12.

Positive Tourniquet Test

 

 

 

 

 

 

 

 

2.Complete Blood Count

CBC. In patients with dengue, the leukocyte counts are often low, and the patient may even be neutropenic. Platelet levels should also be checked, and you should do serial hematocrits for hemoconcentration.

 

 

 

 

 

 

3.Chemistry Test

  • Albumin :  ratio of albumin:globulin less than 1
  • SGOT,SGPT  : increase
  • ALP, GGT and bilirubin : normal
  • Electrolyte  : hyponatremia = level of sodium(Na+) and chloride(Cl)  is very low

 

4.Isolation

Specimens :  serum, plasma, buffy coat ( 3 – 5 days),tissue autopsy 

Host :  Mosquitoes ~ Aedes albopictus

                                       ~ Toxorhynchitis splendens

 

Cell culture  :  C6 / 36,  LLC – MK2, Macrophage cell line

Animals  :  brain of suckling mice

 

5.Serodiagnosis (Antibody detection)

Seroconversion,  > 4 rising

  • Haemagglutination inhibition assay (HAI)
  • Complement fixation (CF)
  • Neutralisation test (NT)
  • Enzyme-linked Immunosorbent assay (ELISA)
  • Rapid Immunochromatographic test

 

6.Molecular diagnosis (Nucleic acid detection)

 

7.Dengue NS1 antigen detection

ELISA

  •   Dengue NS1 antigen could be detected as early as 1 day after onset
  •   Use Dengue NS1 antigen test in first sera with negative-antibody

            IgM < 40   increased 40% of dengue cases

            IgG < 100 increased 54% of dengue cases

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