Chhina et al classified bleeding in patients with dengue fever. Hemorrhage may occur across the spectrum of dengue fever, dengue hemorrhagic fever and dengue shock syndrome. The authors are from Dayanand Medical College in Ludhiana, India.
Sites of bleeding may include:
(1) skin
(2) mucous membranes of the head and neck (epistaxis, gums)
(3) eyes
(4) lungs (with hemoptysis)
(5) gastrointestinal tract (with hematemesis, hematochezia and melena)
The authors noted that early detection of hemoconcentration and shock was essential. There was a lack of association between hemorrhagic manifestations and thrombocytopenia, and platelet transfusions did not improve outcomes in most patients with significant hemorrhage.
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