Successful Outpatient Management of Children at a Secondary Care Hospital in Pakistan in a Dengue Fever Epidemic and Their Clinical Outcomes
Table 3
Identification of admission criteria among six children with dengue fever managed on outpatient basis that showed signs of deterioration on follow-up1.
Parameters
Patient 1
Patient 2
Patient 3
Patient 4
Patient 5
Patient 6
Duration of fever at initial presentation (days)
3
3
2
3
3
2
Duration of fever when admitted (days)
6
7
7
6
7
6
Criteria for admission Dengue with warning signs
Abdominal pain or tenderness
+
+
+
Persistent vomiting
Clinical signs of fluid accumulation
Mucosal bleed
+
+
+
+
+
+
Lethargy, restlessness
+
+
+
Liver enlargement >2 cm
+
+
Laboratory: increase in hematocrit with concurrent rapid fall in platelets
+
−
+
+
+
+
Criteria for severe dengue
Severe plasma leakage leading to: Shock (DSS) OR Fluid accumulation with respiratory distress Severe bleeding as evaluated by clinician Severe organ involvement Liver; AST, or ALT ≥1000 CNS; impaired consciousness Heart and other organs
+
+
+
Duration of hospitalization (days)
8
14
7
10
5
4
1Five children had warning signs, while one child had severe dengue according to WHO Criteria. AST: aspartate transaminase; ALT: alanine transaminase; CNS: central nervous system; DSS: dengue shock syndrome.
