title: Tropical fevers: Management guidelines.
abstract: Tropical fevers were defined as infections that are prevalent in, or are unique to tropical and subtropical regions. Some of these occur throughout the year and some especially in rainy and post-rainy season. Concerned about high prevalence and morbidity and mortality caused by these infections, and overlapping clinical presentations, difficulties in arriving at specific diagnoses and need for early empiric treatment, Indian Society of Critical Care Medicine (ISCCM) constituted an expert committee to develop a consensus statement and guidelines for management of these diseases in the emergency and critical care. The committee decided to focus on most common infections on the basis of available epidemiologic data from India and overall experience of the group. These included dengue hemorrhagic fever, rickettsial infections/scrub typhus, malaria (usually falciparum), typhoid, and leptospira bacterial sepsis and common viral infections like influenza. The committee recommends a 'syndromic approach' to diagnosis and treatment of critical tropical infections and has identified five major clinical syndromes: undifferentiated fever, fever with rash / thrombocytopenia, fever with acute respiratory distress syndrome (ARDS), fever with encephalopathy and fever with multi organ dysfunction syndrome. Evidence based algorithms are presented to guide critical care specialists to choose reliable rapid diagnostic modalities and early empiric therapy based on clinical syndromes.
authors.affiliation: Department of Pediatrics and In-charge PICU and Emergency Services, PGIMER, Chandigarh, India.
authors.forename: Sunit
authors.initials: S
authors.lastname: Singhi
authors.affiliation: Department of Pulmonology and Critical Care PGIMS, Haryana, India.
authors.forename: Dhruva
authors.initials: D
authors.lastname: Chaudhary
authors.affiliation: Infectious disease, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: George M
authors.initials: GM
authors.lastname: Varghese
authors.affiliation: Department of Internal Medicine, PGIMER, Chandigarh, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Bhalla
authors.affiliation: Department of Pediatrics, PGIMER, Chandigarh, India.
authors.forename: N
authors.initials: N
authors.lastname: Karthi
authors.affiliation: Department of Internal Medicine, JLN Medical College Wardha, Wardha, Maharashtra, India.
authors.forename: S
authors.initials: S
authors.lastname: Kalantri
authors.affiliation: Critical Care Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: J V
authors.initials: JV
authors.lastname: Peter
authors.affiliation: Consultant Physician and Intensivist, Ahmedabad, Gujarat, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Mishra
authors.affiliation: Consultant Intensivist, Apex Hospital, Bhopal, Madhya Pradesh, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Bhagchandani
authors.affiliation: Consultant Intensivist, Jeevanrekha Critical Care and Trauma Hospital, Jaipur, Rajasthan, India.
authors.forename: M
authors.initials: M
authors.lastname: Munjal
authors.affiliation: Professor Emeritus Pathology, PGIMS, Rohtak, Haryana, India.
authors.forename: T D
authors.initials: TD
authors.lastname: Chugh
authors.affiliation: Critical Care Medicine, Jeevanrekha Critical Care and Trauma Hospital, Jaipur, Rajasthan, India.
authors.forename: Narendra
authors.initials: N
authors.lastname: Rungta
keywords: Dengue; Guidelines; Influenza; Leptospirosis; Malaria; Scrub typhus; Sepsis; Tropical fever; Typhoid