Dengue Virus

🔴 Dengue Viral Illness: Key Monitoring Parameters

**Dengue viral illness** can still be **deadly** and requires **close monitoring** of **critical hematological and biochemical parameters**. ❌ **Platelet count alone is NOT a key indicator of severity**.

✅ Three Most Important Parameters to Monitor:

1. Hematocrit (PCV): Sudden **increase in PCV** may indicate **plasma leakage**, a warning sign of **severe dengue**.
2. Activated Partial Thromboplastin Time (APTT): Prolonged **APTT** suggests **coagulation abnormalities** and increased risk of **bleeding complications**.
3. Liver Enzymes & PT/INR: **Elevated liver enzymes** with abnormal **prothrombin time (PT) / INR** indicate **hepatic involvement**, a marker of **severe dengue**.

❌ Misconception: Thrombocytopenia (Low Platelet Count) Alone is Harmless

**Thrombocytopenia**, even if significant, is **not necessarily dangerous**. Unwarranted **platelet transfusions** can lead to **TRALI (Transfusion-Related Acute Lung Injury)**, a **serious complication** in dengue patients.

⚠️ When to Consider Platelet Transfusions?

👉 **Platelet transfusions are NOT needed if counts are above 20,000**, 👉 **Unless there are obvious bleeding manifestations**.

🚨 Rare But Critical Complication: HLH (Hemophagocytic Lymphohistiocytosis)

**HLH is a rare but life-threatening complication of dengue.** **Key signs of HLH:** Rapid clinical deterioration with high inflammatory markers. **Action:** Use **H score or HLH diagnostic criteria** in case of suspicion and **immediately shift the patient to a higher center** if required.

📌 Key Takeaway:

**In any infection, detecting organ dysfunction early is crucial.** **Delays in recognition can become life-threatening.**