Are of that assesses the combined accuracy of dengue clinical criteria

    Joe Bowling
    By Joe Bowling
    Pending Moderator Review

    When the SN-38web INIFIOCRUZ clinical criteria was positive, then the NS1 rapid test should be done. This may be because both hemoconcentration and platelet drop are usually not seen in the first days of disease [34].Table 1 Epidemiological characteristics of 325 febrile patients, Rio de Janeiro, March pril,Median (IQR) Dengue 4 (N = 148) Age in years Hematocrit ( ) Leucocyte counts (cells/mm3) Platelet counts (cells/ mm3)IQR interquartile rangeNon dengue (N = 177) 36.5 (23.0?0.0) 42.2 (40.0?4.0) 7518 (5467?900) 256,4945 (221,000?84,667)p-value 0.99 0.45 PubMed ID: criteria and a NS1 point-of-care immunoassay for early diagnosis in outpatients during a DENV-4 epidemic. The WHO 1997 criteria was better to rule out the disease. When the INIFIOCRUZ clinical criteria was positive, then the NS1 rapid test should be done. Patients with a positive strip test should be treated as dengue cases; however, negative results should be monitored for dengue or other acute febrile illnesses. As the clinical diagnosis lacks specificity, a definitive dengue case may PubMed ID: need laboratory confirmation. According to Lima, et al. [17], RT-PCR used in the present research showed 90 sensitivity and more than 95 specificity on the second day after the onset of disease, the same median time obtained in our sample. It is reasonable to consider this as a good diagnostic tool to confirm dengue fever. However, considering false negative results, we excluded 12 patients with negative RT-PCR and a positive or indeterminate IgM or PlateliaTM NS1 results in which we could not identify the serotype. At the time the study population was evaluated, there were no reports of any other Flavivirus circulating simultaneously in the city of Rio de Janeiro that could interfere in dengue laboratory results. We believe that we obtained a true non-dengue set of patients. We also evaluated the ability of hematological parameters and individual signs and symptoms to discriminate dengue from non-dengue. We found that leukopenia was more frequent in D4 than in ND, although the overlapping range between the two groups prevented an adequate discrimination between them. The relevance of leukopenia as a discriminant feature of dengue infection has been previously documented, although the cutoff values may vary [13, 31?4]. The platelet counts were lower in the D4 group, although true thrombocytopenia was infrequent in both groups.