The usefulness of clinical-practice-based laboratory data in facilitating the diagnosis of dengue illness.
Alertness to dengue and making a timely diagnosis is extremely important in the treatment of dengue and containment of dengue epidemics. We evaluated the complementary role of clinical-practice-based laboratory data in facilitating suspicion/diagnosis of dengue. One hundred overall dengue (57 dengue fever [DF] and 43 dengue hemorrhagic fever [DHF]) cases and another 100 nondengue cases (78 viral infections other than dengue, 6 bacterial sepsis, and 16 miscellaneous diseases) were analyzed. We separately compared individual laboratory variables (platelet count [PC] , prothrombin time [PT], activated partial thromboplastin time [APTT], alanine aminotransferase [ALT], and aspartate aminotransferase [AST]) and varied combined variables of DF and/or DHF cases with the corresponding ones of nondengue cases. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) in the diagnosis of DF and/or DHF were measured based on these laboratory variables. While trade-off between sensitivity and specificity, and/or suboptimal PPV/NPV was found at measurements using these variables, prolonged APTT + normal PT + PC < 100 × 10(9) cells/L had a favorable sensitivity, specificity, PPV, and NPV in diagnosis of DF and/or DHF. In conclusion, these data suggested that prolonged APTT + normal PT + PC < 100 × 10(9) cells/L is useful in evaluating the likelihood of DF and/or DHF.
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan ; Infection Control Team, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan ; Chang Gung University College of Medicine, Tao-Yuan 333, Taiwan.
Jien-Wei
JW
Liu
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan ; Infection Control Team, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan ; Chang Gung University College of Medicine, Tao-Yuan 333, Taiwan.
Ing-Kit
IK
Lee
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
Lin
L
Wang
Department of Medical Research, Show Chwan Memorial Hospital-Chang Bing, Changhua 500, Taiwan.
Rong-Fu
RF
Chen
Department of Medical Research, Show Chwan Memorial Hospital-Chang Bing, Changhua 500, Taiwan.
Kuender D
KD
Yang
D000293:Adolescent; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D003716:Dengue Virus / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011517:Prothrombin Time; D019595:Severe Dengue / Q000097:blood / Q000175:diagnosis*
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase