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Division of Vector-Borne Infectious Diseases Dengue: Clinical Manifestations and Epidemiology

 
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Four Grades of DHF

  • Grade 1
    • Fever and nonspecific constitutional symptoms
    • Positive tourniquet test is only hemorrhagic manifestation
  • Grade 2
    • Grade 1 manifestations + spontaneous bleeding
  • Grade 3
    • Signs of circulatory failure (rapid/weak pulse, narrow pulse pressure, hypotension, cold/clammy skin)
  • Grade 4
    • Profound shock (undetectable pulse and BP)

There are four grades of DHF. For all grades the four criteria for DHF must be met.

  1. In Grade 1, fever and nonspecific constitutional symptoms are present and the only hemorrhagic manifestation is provoked, that is, a positive tourniquet test (which will soon be described).
  2. In Grade 2, in addition to the Grade I manifestations, there is spontaneous bleeding.
  3. Grades 3 and 4 are Dengue Shock Syndrome. Grade 3 is incipient shock with signs of circulatory failure.
  4. In Grade 4, the patient has profound shock, with undetectable pulse and blood pressure.

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This page last reviewed February 13, 2002

Division of Vector-Borne Infectious Diseases |
National Center for Infectious Diseases |
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