Materiały źródłowe

• #1 LABORATORY DIAGNOSIS AND DIAGNOSTIC TESTS – Dengue – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK143156/

  Efficient and accurate diagnosis of dengue is of primary importance for clinical care (i.e. early detection of severe cases, case confirmation and differential diagnosis with other infectious diseases), surveillance activities, outbreak control, pathogenesis, academic research, vaccine development, and clinical trials. […] Laboratory diagnosis methods for confirming dengue virus infection may involve detection of the virus, viral nucleic acid, antigens or antibodies, or a combination of these techniques. […] At the end of the acute phase of infection, serology is the method of choice for diagnosis. […] To distinguish primary and secondary dengue infections, IgM/IgG antibody ratios are now more commonly used than the haemagglutination-inhibition test (HI). […] A range of laboratory diagnostic methods has been developed to support patient management and disease control.

• #1 Clinical Testing Guidance for Dengue | Dengue | CDC

  https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html

  Clinicians should consider dengue in patients with fever, who live in or recently traveled to areas with risk of dengue. In addition to fever, common dengue symptoms include severe headache, retro-orbital pain, myalgia and arthralgia, macular or maculopapular rash. […] For acute dengue diagnosis, clinicians should order NS1 ELISA and IgM tests or NAAT and IgM tests. […] During this period, laboratory diagnosis should be made on serum samples using either one of these test combinations: A nucleic acid amplification test (NAAT) (e.g., RT-PCR) and an IgM antibody test OR A NS1 ELISA test and an IgM detection test. […] A serum sample is preferred for dengue testing. […] Dengue virus RNA can be detected with NAAT in blood, serum, and plasma. Most of these tests identify the infecting dengue virus serotype. A positive NAAT test does not require further confirmatory testing.

• #1 LABORATORY DIAGNOSIS AND DIAGNOSTIC TESTS – Dengue – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK143156/

  In general, tests with high sensitivity and specificity require more complex technologies and technical expertise, while rapid tests may compromise sensitivity and specificity for the ease of performance and speed. […] Virus isolation and nucleic acid detection are more labour-intensive and costly but are also more specific than antibody detection using serologic methods. […] Early laboratory confirmation of clinical diagnosis may be valuable because some patients progress over a short period from mild to severe disease and sometimes to death. Early intervention may be life-saving. […] Before day 5 of illness, during the febrile period, dengue infections may be diagnosed by virus isolation in cell culture, by detection of viral RNA by nucleic acid amplification tests (NAAT), or by detection of viral antigens by ELISA or rapid tests.

• #1 LABORATORY DIAGNOSIS AND DIAGNOSTIC TESTS – Dengue – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK143156/

  In drug trials, patients should have confirmed etiological diagnosis. […] Specimens for virus isolation should be collected early in the course of the infection, during the period of viraemia (usually before day 5). […] Cell culture is the most widely used method for dengue virus isolation. […] The mosquito cell line C6/36 (cloned from Ae. albopictus) or AP61 (cell line from Ae. pseudoscutellaris) are the host cells of choice for routine isolation of dengue virus. […] When no other methods are available, clinical specimens may also be inoculated by intracranial route in suckling mice or intrathoracic inoculation of mosquitoes. […] Since the 1990s, several reverse transcriptase-polymerase chain reaction (RT-PCR) assays have been developed. […] The real-time RT-PCR assay is a one step assay system used to quantitate viral RNA and using primer pairs and probes that are specific to each dengue serotype.

• #1 LABORATORY DIAGNOSIS AND DIAGNOSTIC TESTS – Dengue – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK143156/

  The NASBA (nucleic acid sequence based amplification) assay is an isothermal RNA-specific amplification assay that does not require thermal cycling instrumentation. […] Until recently, detection of dengue antigens in acute-phase serum was rare in patients with secondary infections because such patients had pre-existing virus-IgG antibody immunocomplexes. […] The IgG ELISA is used for the detection of recent or past dengue infections (if paired sera are collected within the correct time frame). […] A dengue virus E/M protein-specific IgM/IgG ratio can be used to distinguish primary from secondary dengue virus infections. […] Positive detection for serum anti-dengue IgA as measured by anti-dengue virus IgA capture ELISA (AAC-ELISA) often occurs one day after that for IgM. […] The haemagglutination-inhibition (HI) test is based on the ability of dengue antigens to agglutinate red blood cells (RBC) of ganders or trypsinized human O RBC.

• #1 LABORATORY DIAGNOSIS AND DIAGNOSTIC TESTS – Dengue – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK143156/

  Unfortunately, an ideal diagnostic test that permits early and rapid diagnosis, is affordable for different health systems, is easy to perform, and has a robust performance, is not yet available. […] If specimens are collected after day 5 of illness, commercial IgM ELISA or sensitive dengue IgM rapid tests may suggest a dengue outbreak, but results are preferably confirmed with reliable serological tests performed in a reference laboratory with broad arbovirus diagnostic capability. […] The NS1 glycoprotein is produced by all flaviviruses and is secreted from mammalian cells. NS1 produces a very strong humoral response. Many studies have been directed at using the detection of NS1 to make an early diagnosis of dengue virus infection. […] The microneutralization assay is based on the same principle as PRNT.

• #1

  https://www.parkwayeast.com.sg/conditions-diseases/dengue-fever/diagnosis-treatment

  Testing for dengue fever is done to determine whether a person with signs and symptoms, and recent potential exposure, has been infected with the dengue virus. The infection is difficult to diagnose without laboratory tests because symptoms may initially resemble those of other diseases. […] Your doctor will assess your symptoms and your medical history. If the clinical suspicion of dengue fever is high, blood tests would be undertaken. These include a full blood count and may include the following: […] Dengue virus antigen detection (NS1): This detects the NS1 protein of the dengue virus, which is secreted into the blood during dengue infection. NS1 is detectable during the acute phase of dengue virus infections, usually during the febrile period or up to first 7 days of symptoms. It can be as sensitive as molecular tests during this period.

• #1 Clinical Testing Guidance for Dengue | Dengue | CDC

  https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html

  The presence of the dengue virus non-structural protein 1 (NS1) in blood (serum) during the first 7 days of illness is indicative of a current or recent dengue virus infection. […] A negative result from a RT-PCR or NS1 ELISA test does not rule out infection. […] A positive result by RT-PCR or NS1 ELISA meets the confirmatory laboratory criteria for diagnosis in the National Notifiable Diseases Surveillance System (NNDSS) dengue case definition. […] IgM ELISA is recommended as the primary test after day 7 of symptom onset. […] Some patients may be positive on NAAT or NS1 ELISA tests after day 7 of illness. […] Patients with a positive NAAT (E.g., RT-PCR) or NS1 ELISA test have a confirmed acute dengue virus infection. […] Patients who have IgM antibodies against dengue virus in a single sample are classified as having a presumptive, recent dengue virus infection.

• #1 SciELO Brazil – Dengue: a review of the laboratory tests a clinician must know to achieve a correct diagnosis Dengue: a review of the laboratory tests a clinician must know to achieve a correct diagnosis

  https://www.scielo.br/j/bjid/a/fKHcTt5V8fdFKMkWQGrYMLz/

  The main disadvantages of the HI test are its lack of specificity, the need for paired samples, and the inability to identify the infecting virus serotype. […] The NT is the most sensitive and specific serological test for dengue virus diagnosis, and it is detected for a long period of time. […] Up till now, ELISA has been considered the most useful test for dengue diagnosis, due to its high sensitivity and the ease of use. […] MAC-ELISA has been found to be much less sensitive than the HI test in paired serum samples collected during acute phase of the disease. […] The specificity of MAC-ELISA is similar to that of HI in primary infections, as well as in secondary infections, when a monotypic response can be observed, but in general the response is cross-reactive to all dengue serotypes and to other flaviviruses.

• #1 LABORATORY DIAGNOSIS AND DIAGNOSTIC TESTS – Dengue – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK143156/

  After day 5, dengue viruses and antigens disappear from the blood coincident with the appearance of specific antibodies. […] Dengue serologic tests are more available in dengue-endemic countries than are virological tests. […] Results of rapid tests may be available within less than one hour. Reliance on rapid tests to diagnose dengue infections should be approached with caution, however, since the performance of all commercial tests has not yet been evaluated by reference laboratories. […] A four-fold or greater increase in antibody levels measured by IgG ELISA or by haemagglutination inhibition (HI) test in paired sera indicates an acute or recent flavivirus infection. […] Both the identification of virus/viral RNA/viral antigen and the detection of an antibody response are preferable for dengue diagnosis to either approach alone.

• #1 Clinical Testing Guidance for Dengue | Dengue | CDC

  https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html

  All patients with clinically suspected dengue should receive appropriate management without waiting for diagnostic test results. […] Clinical samples can be referred to most state health departments or to commercial laboratories that offer dengue diagnostic testing. […] Cross reactivity is a limitation of dengue serological tests and is seen when antibodies against other flaviviruses react on the dengue IgM test. […] Current dengue molecular tests (E.g., RT-PCR) and NS1 ELISA tests do not have cross-reactivity with other flaviviruses of concern.

• #1 Current Advances in Dengue Diagnosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC440621/

  Molecular diagnosis based on reverse transcription (RT)-PCR, such as one-step or nested RT-PCR, nucleic acid sequence-based amplification (NASBA), or real-time RT-PCR, has gradually replaced the virus isolation method as the new standard for the detection of dengue virus in acute-phase serum samples. […] Two patterns of serological response can be observed in patients with dengue virus infection: primary and secondary antibody responses, depending on the immunological status of the infected individuals. A primary antibody response is seen in individuals who are not immune to flaviviruses. A secondary antibody response is seen in individuals who have had a previous flavivirus infection. […] For acute- and convalescent-phase sera, serological detection of antibodies based on capture immunoglobulin M (IgM) and IgG enzyme-linked immunosorbent assay (ELISA) has become the new standard for the detection and differentiation of primary and secondary dengue virus infections.

• #1 Diagnosis of Dengue Infection Using Conventional and Biosensor Based Techniques

  https://www.mdpi.com/1999-4915/7/10/2877

  Detection of DENV by nucleic acid amplification using RT-PCR is suggestive of an acute infection. This technique provides several advantages including ability to differentiate DENV serotypes, can be a quantitative assay and has higher sensitivity when combined with real-time technology. However, the RT-PCR test is expensive and requires specialized equipment and well-trained personnel, thus, limiting its use in many developing countries. […] Commercial serological assays are commonly used in diagnostic laboratories for dengue confirmations. Serological assays are comparatively simple to perform and the specimens required for the assay, such as serum or plasma, are stable in the tropical climate. Consequently, these techniques can be used in various settings such as surveillance, health care facilities and travel clinics. However, the applicability of serological tests in dengue endemic areas should be evaluated against the potential cross-reactivity with other circulating flaviviruses.

• #1 LABORATORY DIAGNOSIS AND DIAGNOSTIC TESTS – Dengue – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK143156/

  Platelets and haematocrit values are commonly measured during the acute stages of dengue infection. […] A drop of the platelet count below 100 000 per L may be observed in dengue fever but it is a constant feature of dengue haemorrhagic fever. […] Haemoconcentration, as estimated by an increase in haematocrit of 20% or more compared with convalescent values, is suggestive of hypovolaemia due to vascular permeability and plasma leakage.

• #1 Dengue Fever – Symptoms, Causes, Diagnosis and Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Number f

  https://www.pacehospital.com/dengue-fever-causes-symptoms-and-treatments

  Dengue Virus Antigen Detection (NS1) – to confirm Dengue viral infection. This test is useful to diagnose early dengue infection and can be conducted within 1-2 days following Dengue infection. […] In case of severe symptoms Doctors may suggest other blood test and radiology imaging test to know the spread of dengue infection to other organs, these may include: Liver function tests (LFT) – to detect mild elevations in serum bilirubin, elevated transaminases and derangements in serum albumin caused by Aedes mosquito’s virus hepatotoxic effects that can also lead to acute liver failure, with fatal outcomes. […] Renal Function Test (RFT) – to check the elevation of the serum creatinine level that may cause variety of renal diseases such as Acute renal failure, acute tubular necrosis, hemolytic uremic syndrome, hypotension, rhabdomyolysis, proteinuria, glomerulopathy, nephrotic syndrome or hemolysis.

• #1 Dengue: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215840-overview

  During the early phase of the disease (first 4-5 days), virus can be detected in serum, plasma, circulating blood cells, and tissues. Virus isolation, nucleic acid detection, and antigen detection are more useful to diagnose infection. At the end of the acute phase of illness, serology becomes the method of choice. […] The following laboratory tests should also be performed in the workup of patients with possible dengue: Complete blood cell (CBC) count, Metabolic panel, Serum protein and albumin levels, Liver panel, Coagulation panel with or without disseminated intravascular coagulation (DIC) panel. […] Guaiac testing for occult blood in the stool should be performed on all patients in whom dengue virus infection is suspected. Urinalysis identifies hematuria. […] Imaging studies include the following: Chest radiography, Head computed tomography (CT) scanning without contrast: To detect intracranial bleeding or cerebral edema due to severe dengue, Ultrasonography: To detect fluid in the chest and abdominal cavities, pericardial effusion, and a thickened gallbladder wall in patients with severe dengue.

• #1 Dengue Fever – Symptoms, Causes, Diagnosis and Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Number f

  https://www.pacehospital.com/dengue-fever-causes-symptoms-and-treatments

  ECG – to check the heart electrical disturbances. In many patients ECG abnormalities observed mainly sinus bradyarrhythmias, ventricular asystole, sinus tachyarrhythmias, supraventricular tachycardia (SVT) and ST- and T-wave changes due to electrolyte abnormalities of potassium, calcium, magnesium caused by dengue infection. […] Ultrasound abdomen (USG) – to check the conditions like serositis, fluid in abdomen, edema of the gallbladder, pericholecystic fluid, ascites (buildup of fluid in spaces within your abdomen) mainly caused by dengue fever infection. […] Chest X-ray – to check the pleural effusion (the build-up of excess fluid between the layers of the pleura (the tissues that line the lungs and the chest)), pericardial effusion (the buildup of the fluid in the saclike double-layered structure around the heart called as pericardium) caused by dengue fever infection.

• #1 Dengue fever – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dengue-fever/diagnosis-treatment/drc-20353084

  Diagnosing dengue fever can be difficult because its signs and symptoms can be easily confused with those of other diseases such as chikungunya, Zika virus, malaria and typhoid fever. […] Your doctor will likely ask about your medical and travel history. Be sure to describe international trips in detail, including the countries you visited and the dates, as well as any contact you may have had with mosquitoes. […] Your doctor may also draw a sample of blood to be tested in a lab for evidence of infection with one of the dengue viruses.

• #1 Dengue virus infection: Clinical manifestations and diagnosis – UpToDate

  https://www.uptodate.com/contents/dengue-virus-infection-clinical-manifestations-and-diagnosis

  The diagnosis may be confirmed via IgM seroconversion between paired acute and recovery phase (obtained 10 to 14 days after the acute phase) specimens; a diagnosis of acute DENV infection may be established by a fourfold or greater rise in antibody titer. […] Serologic tests are unreliable for diagnosis of acute DENV infection in individuals who have been vaccinated with a dengue vaccine within the previous several months. […] DENV infection can be established by virus isolation (culture); in general, this is not warranted as a clinical diagnostic tool since results are usually not available in a clinically meaningful time frame. […] The differential diagnosis of DENV infection includes: Other viral hemorrhagic fevers […] Chikungunya […] Zika virus infection […] Malaria […] Typhoid fever

• #1 Dengue Fever Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/dengue-fever-test/

  You don’t need any special preparations for a dengue fever test. […] There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. […] A positive test result means that the test found genetic material from the virus in your blood sample. You most likely have a dengue infection. A negative test result means that the dengue virus wasn’t found in your blood sample. You probably don’t have dengue. […] If you have dengue fever, your provider can tell you how to treat your symptoms. Always follow your provider’s instructions. In general, care for dengue fever includes getting plenty of rest, drinking lots of fluids, and taking acetaminophen to control fever and relieve pain.

• #1

  https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue

  Dengue is treated with pain medicine as there is no specific treatment currently. […] There is no specific treatment for dengue. The focus is on treating pain symptoms. Most cases of dengue fever can be treated at home with pain medicine. […] For people with severe dengue, hospitalization is often needed. […] People with these severe symptoms should get care right away. […] Individuals who are infected for the second time are at greater risk of severe dengue. […] Severe dengue symptoms often come after the fever has gone away.

• #1 Evaluation of diagnostic tests: dengue | Nature Reviews Microbiology

  https://www.nature.com/articles/nrmicro2459

  Dengue is an arthropod-borne flavivirus that comprises four distinct serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) that constitute an antigenic complex of the genus flavivirus, family Flaviviridae. […] There is a need for specific, inexpensive dengue diagnostic tests that can be used for clinical management, surveillance and outbreak investigations and would permit early intervention to treat patients and prevent or control epidemics. […] The characteristics of an 'ideal’ dengue diagnostic test depend on the purpose for which the test will be used. […] Laboratory confirmation of dengue infection relies on isolation of the virus in cell culture, the identification of viral nucleic acid or antigens, or the detection of virus-specific antibodies. […] Direct virus detection could potentially be used for early, definitive and serotype-specific identification of dengue infections during the acute phase of the disease.

• #1

  https://www.who.int/activities/enhancing-dengue-diagnosis-and-case-management

  These differing IgM response patterns to infection underscore the need to evaluate the sensitivity and specificity of commercially available tests, especially for diagnosis of secondary dengue virus infections. […] A successful clinical outcome requires effective and early management of cases provided by clinical evaluation of hydration and recognition of comorbid conditions, accurate differential diagnosis, supported by rapid laboratory assessment/confirmation and early response to severe disease. […] The national clinical dengue management guidelines should be referred to for further details.

• #2 Dengue virus infection: Clinical manifestations and diagnosis – UpToDate

  https://www.uptodate.com/contents/dengue-virus-infection-clinical-manifestations-and-diagnosis

  Dengue virus infection: Clinical manifestations and diagnosis […] Issues related to clinical manifestations and diagnosis of DENV infection will be reviewed here. […] Case definitions without laboratory confirmation may be used to make a provisional diagnosis in epidemiologic situations that support a high pretest probability of DENV infection. Otherwise, laboratory confirmation for DENV infection, such as detection of viruses or viral components or serology, is necessary to make a diagnosis. […] The diagnosis of DENV infection should be suspected in febrile individuals with typical clinical manifestations (fever, headache, nausea, vomiting, retro-orbital pain, myalgia, arthralgia, rash, hemorrhagic manifestations, positive tourniquet test, leukopenia) and relevant epidemiologic exposure (residence in or travel within the past two weeks to an area with mosquito-borne transmission of DENV infection).

• #2

  https://www.who.int/activities/enhancing-dengue-diagnosis-and-case-management

  Laboratory confirmation of dengue virus infection is important. […] Diagnosis may involve detection of the virus, viral nucleic acid, antigens or antibodies, or a combination of these entities. […] Laboratory tests using NS1 (non-structural protein 1) antigen can provide early diagnosis in febrile patients. […] During the acute stage of the disease, virus isolation, nucleic acid or antigen detection can be used to diagnose the infection. […] At the end of the acute phase of infection, serology is the method of choice for diagnosis. […] Serological assays to detect specific immunoglobulin M (IgM) or immunoglobulin G (IgG) antibodies to dengue virus are widely available and can provide an alternative to virus isolation or polymerase chain reaction to support the diagnosis of dengue fever.

• #2 Current Advances in Dengue Diagnosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC440621/

  For virus detection, virus isolation by cell culture and from mosquitoes remains the gold standard, although it has gradually been replaced by the RT-PCR method for rapid diagnosis. […] The field of molecular diagnosis has changed significantly over the past decade, leading to assays that are much more reliable for the detection and characterization of various pathogens. […] More recently, several investigators have reported on fully automatic real-time RT-PCR assays for the detection of dengue virus in acute-phase serum samples. […] The serological diagnosis of dengue virus infection is rather complicated for the following reasons: (i) patients may have multiple and sequential infections with the four dengue virus serotypes due to a lack of cross-protective neutralization antibodies; (ii) multiple and sequential flavivirus infections make differential diagnosis difficult due to the presence of preexisting antibodies and original antigenic sin.

• #2 Dengue Virus Laboratory Diagnosis

  https://www.labce.com/spg988985_dengue_virus_laboratory_diagnosis.aspx?srsltid=AfmBOooQjVDFd6nWgh2o5IWpBknudM1feEiUsqnbJDF7hu1Zsf5Fr_Zr

  Molecular methods Reverse transcription-polymerase chain reaction (RT-PCR) can detect dengue virus in the blood during the first five days of symptoms with a sensitivity of 80-90% and a specificity of 95%. […] The recommended serological test is an IgM antibody capture enzyme-linked immunosorbant assay (MAC-ELISA). […] Positive patient serum can be confirmed by plaque reducing neutralization test for antibodies. […] Acute specimens drawn by day five and a convalescent specimen at day ten or later are required to demonstrate a four-fold rise in titer for a definitive diagnosis by serology. […] Dengue tests for nonstructural 1 (NS1) glycoprotein antigen and antibody tests have shown cross-reactivity with other flaviviruses. […] Classical testing algorithms of dengue if molecular tests are negative: MAC ELISA, IgG ELISA, Plaque reduction and neutralization test (PRNT).

• #2 Dengue Virus: A Diagnostic Testing Update – Insights

  https://news.mayocliniclabs.com/2020/01/06/dengue-virus-a-diagnostic-testing-update/

  At the time of mosquito transmission viremia rapidly spikes and is detectable by molecular methods for the first 4 to 6 days following symptom onset and during acute disease. […] So keeping these analyte profiles in mind, I’ll first focus on NAAT testing to detect dengue virus RNA. This methodology is most useful during acute disease, again typically within the first five days of symptom onset, during which time viral titers are still elevated. […] Importantly, a negative NAAT result for dengue virus should not be used to rule out infection, and providers are strongly encouraged to follow up with serologic testing if risk of infection is high. […] A second marker for detection of dengue virus infection is the NS1 antigen. NS1 is a conserved nonstructural glycoprotein that has approximately 80% amino acid similarity between the four dengue virus serotypes and is secreted from infected host cells.

• #2 Clinical Testing Guidance for Dengue | Dengue | CDC

  https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html

  The presence of the dengue virus non-structural protein 1 (NS1) in blood (serum) during the first 7 days of illness is indicative of a current or recent dengue virus infection. […] A negative result from a RT-PCR or NS1 ELISA test does not rule out infection. […] A positive result by RT-PCR or NS1 ELISA meets the confirmatory laboratory criteria for diagnosis in the National Notifiable Diseases Surveillance System (NNDSS) dengue case definition. […] IgM ELISA is recommended as the primary test after day 7 of symptom onset. […] Some patients may be positive on NAAT or NS1 ELISA tests after day 7 of illness. […] Patients with a positive NAAT (E.g., RT-PCR) or NS1 ELISA test have a confirmed acute dengue virus infection. […] Patients who have IgM antibodies against dengue virus in a single sample are classified as having a presumptive, recent dengue virus infection.

• #2

• #2

  https://www.parkwayeast.com.sg/conditions-diseases/dengue-fever/diagnosis-treatment

  Testing for dengue fever is done to determine whether a person with signs and symptoms, and recent potential exposure, has been infected with the dengue virus. The infection is difficult to diagnose without laboratory tests because symptoms may initially resemble those of other diseases. […] Your doctor will assess your symptoms and your medical history. If the clinical suspicion of dengue fever is high, blood tests would be undertaken. These include a full blood count and may include the following: […] Dengue virus antigen detection (NS1): This detects the NS1 protein of the dengue virus, which is secreted into the blood during dengue infection. NS1 is detectable during the acute phase of dengue virus infections, usually during the febrile period or up to first 7 days of symptoms. It can be as sensitive as molecular tests during this period.

• #2

  https://www.parkwayeast.com.sg/conditions-diseases/dengue-fever/diagnosis-treatment

  Antibody tests: This is a dengue test for IgM antibodies. Dengue virus-specific IgM and neutralising antibodies typically develop toward the end of the first week of illness. They are generally positive starting 4 5 days after the onset of symptoms, and continues for approximately 12 weeks afterwards, but may persist longer. […] Dengue test for IgG antibodies: Antibodies are produced more slowly in response to an infection. Typically, the level rises with an acute infection, stabilises, and then persists long-term. Individuals who have been exposed to the virus prior to the current infection maintain a level of IgG antibodies in the blood.

• #2 Dengue Virus: A Diagnostic Testing Update – Insights

  https://news.mayocliniclabs.com/2020/01/06/dengue-virus-a-diagnostic-testing-update/

  The final diagnostic method to discuss is standard serology for detection of IgM and IgG class antibodies to dengue virus. […] Many of the assays used currently at various reference laboratories and the CDC are laboratory developed and have variable sensitivity and specificity performance characteristics ranging from 60% to almost 100%. A recently FDA-cleared IgM assay has been introduced and is currently used at Mayo Clinic Laboratories with a sensitivity and specificity of approximately 88% and 100% respectively, compared to other commercially available laboratory assays. […] Important to note, however, is that cross-reactivity with antibodies to other flaviviruses can occur, including with antibodies to West Nile virus, which is now endemic in the United States. […] With regards to IgG antibodies, these usually become detectable roughly 10 days following symptom onset. The presence of IgG antibodies only is indicative of past exposure to dengue virus, and similar to the limitation of IgM antibodies, cross-reactivity of IgG class antibodies to other flaviviruses can occur.

• #2 Dengue: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215840-overview

  During the early phase of the disease (first 4-5 days), virus can be detected in serum, plasma, circulating blood cells, and tissues. Virus isolation, nucleic acid detection, and antigen detection are more useful to diagnose infection. At the end of the acute phase of illness, serology becomes the method of choice. […] The following laboratory tests should also be performed in the workup of patients with possible dengue: Complete blood cell (CBC) count, Metabolic panel, Serum protein and albumin levels, Liver panel, Coagulation panel with or without disseminated intravascular coagulation (DIC) panel. […] Guaiac testing for occult blood in the stool should be performed on all patients in whom dengue virus infection is suspected. Urinalysis identifies hematuria. […] Imaging studies include the following: Chest radiography, Head computed tomography (CT) scanning without contrast: To detect intracranial bleeding or cerebral edema due to severe dengue, Ultrasonography: To detect fluid in the chest and abdominal cavities, pericardial effusion, and a thickened gallbladder wall in patients with severe dengue.

• #2 Dengue Fever – Symptoms, Causes, Diagnosis and Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Number f

  https://www.pacehospital.com/dengue-fever-causes-symptoms-and-treatments

  D-dimer – to check D-dimer value in the blood, D-dimer is a protein fragment made when a blood clot dissolves in your body. Dengue fever infection can increase the D-dimer levels in the blood and that can result pain in body, sharp chest pain, high fever, trouble breathing and changes in skin color of your arm or leg. […] 2D echocardiography (2D Echo) – to check the damage to heart muscles. Severe dengue fever affects the heart structurally and functionally. Cardiac complications secondary to dengue virus infection vary from self-limiting arrhythmias to severe myocardial infarction, leading to hypotension, pulmonary edema, and cardiogenic shock. […] A fibrinogen test – to check fibrinogen levels, Fibrinogen is a blood protein made in liver and helps blood clotting. Low fibrinogen may make it difficult for blood to clot. In case of complicated dengue hemorrhagic fever patients have tendency of excessive bleeding, doctor may go for this test to check your fibrinogen levels. […] Fibrin degradation products blood test – to check the FDP levels, Fibrin degradation products (FDPs) are the substances left behind when clots dissolve in the blood. Increased FDPs may be a sign of primary or secondary fibrinolysis (clot-dissolving activity) due to dengue hemorrhagic fever.

• #2 Dengue virus infection: Clinical manifestations and diagnosis – UpToDate

  https://www.uptodate.com/contents/dengue-virus-infection-clinical-manifestations-and-diagnosis

  The diagnosis may be confirmed via IgM seroconversion between paired acute and recovery phase (obtained 10 to 14 days after the acute phase) specimens; a diagnosis of acute DENV infection may be established by a fourfold or greater rise in antibody titer. […] Serologic tests are unreliable for diagnosis of acute DENV infection in individuals who have been vaccinated with a dengue vaccine within the previous several months. […] DENV infection can be established by virus isolation (culture); in general, this is not warranted as a clinical diagnostic tool since results are usually not available in a clinically meaningful time frame. […] The differential diagnosis of DENV infection includes: Other viral hemorrhagic fevers […] Chikungunya […] Zika virus infection […] Malaria […] Typhoid fever

• #2 Dengue Differential Diagnoses

  https://emedicine.medscape.com/article/215840-differential

  Studies indicate that as many as 50% of dengue cases may be misdiagnosed, as a result of inaccurate assessment of the signs and symptoms of disease presentation. This inaccuracy can lead to increased cost of treatment, such as unneeded hospitalizations, as well as possibly increased morbidity and mortality due to volume overload from overzealous use of intravenous fluids. […] A Belgian study examined predictors of diagnosis in 1962 febrile travelers and expatriates returning from the tropics. After malaria was ruled out, the main predictors of dengue infection included skin rash, thrombocytopenia, and leukopenia. […] Dengue must be carefully differentiated from preeclampsia during pregnancy. An overlap of symptoms and signs, including thrombocytopenia, impaired liver function, capillary leak, ascites, and decreased urine output may make this clinically challenging. Definitive diagnosis is confirmed via serology.

• #2

  https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue

  Dengue is treated with pain medicine as there is no specific treatment currently. […] There is no specific treatment for dengue. The focus is on treating pain symptoms. Most cases of dengue fever can be treated at home with pain medicine. […] For people with severe dengue, hospitalization is often needed. […] People with these severe symptoms should get care right away. […] Individuals who are infected for the second time are at greater risk of severe dengue. […] Severe dengue symptoms often come after the fever has gone away.

• #2 Dengue Fever: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17753-dengue-fever

  Dengue fever is diagnosed with a blood test. Your healthcare provider will take a sample of blood through a vein and send it to a lab to look for signs of dengue virus. This may also identify which of the four versions you have. Your provider can use a blood test to look for other viruses that cause similar symptoms. […] Theres no medicine that treats dengue fever. Your healthcare provider will give you recommendations on how to manage your symptoms and if and when you should go to the ER. […] Managing your symptoms is the only way to treat dengue fever. Follow your healthcare providers recommendations, which may include: Keeping yourself hydrated by drinking plenty of water and fluids. Getting as much rest as possible. Treating pain with acetaminophen (like Tylenol) only. Do not take ibuprofen (like Advil) or aspirin. This can increase your risk of life-threatening internal bleeding.

• #2 Evaluation of diagnostic tests: dengue | Nature Reviews Microbiology

  https://www.nature.com/articles/nrmicro2459

  Dengue is an arthropod-borne flavivirus that comprises four distinct serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) that constitute an antigenic complex of the genus flavivirus, family Flaviviridae. […] There is a need for specific, inexpensive dengue diagnostic tests that can be used for clinical management, surveillance and outbreak investigations and would permit early intervention to treat patients and prevent or control epidemics. […] The characteristics of an 'ideal’ dengue diagnostic test depend on the purpose for which the test will be used. […] Laboratory confirmation of dengue infection relies on isolation of the virus in cell culture, the identification of viral nucleic acid or antigens, or the detection of virus-specific antibodies. […] Direct virus detection could potentially be used for early, definitive and serotype-specific identification of dengue infections during the acute phase of the disease.

• #3

  https://www.parkwayeast.com.sg/conditions-diseases/dengue-fever/diagnosis-treatment

  Testing for dengue fever is done to determine whether a person with signs and symptoms, and recent potential exposure, has been infected with the dengue virus. The infection is difficult to diagnose without laboratory tests because symptoms may initially resemble those of other diseases. […] Your doctor will assess your symptoms and your medical history. If the clinical suspicion of dengue fever is high, blood tests would be undertaken. These include a full blood count and may include the following: […] Dengue virus antigen detection (NS1): This detects the NS1 protein of the dengue virus, which is secreted into the blood during dengue infection. NS1 is detectable during the acute phase of dengue virus infections, usually during the febrile period or up to first 7 days of symptoms. It can be as sensitive as molecular tests during this period.

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