Journal Article

Noninvasive Measurement of Microvascular Leakage in Patients with Dengue Hemorrhagic Fever

Delia B. Bethell, John Gamble, Pham Phu Loc, Nguyen Minh Dung, Tran Thi Hong Chau, Ha Thi Loan, Tran Thi Nhu Thuy, Dong Thi Hoai Tam, Ivor B. Gartside, Nicholas J. White and Nicholas P. J. Day

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 2, pages 243-253
Published in print January 2001 | ISSN: 1058-4838
Published online January 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/318453
Noninvasive Measurement of Microvascular Leakage in Patients with Dengue Hemorrhagic Fever

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Dengue shock syndrome (DSS) is a potentially lethal complication of dengue virus infection associated with hypotension and leakage of plasma water into the extravascular space. To determine whether the underlying pathophysiology of DSS is distinct from that in milder forms of the disease, we assessed microvascular permeability, by use of strain gauge plethysmography, in Vietnamese children with DSS (n = 19), or dengue hemorrhagic fever (DHF) without shock (n = 16), and in healthy control children (n = 15). At admission and after fluid resuscitation, the mean coefficient of microvascular permeability (Kf) for the patients with dengue was ∼50% higher than that for the control patients (P = .02). There was no significant difference in Kf between the 2 groups of patients with dengue; this suggests the same underlying pathophysiology. We hypothesize that in patients with DSS, the fluctuations in Kf are larger than those in patients with DHF, which leads to short-lived peaks of markedly increased microvascular permeability and consequent hemodynamic shock.

Journal Article.  6187 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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