Specificity of Hess Test as a Marker of DHF

Abstract

Abstract

Objectives: Dengue Fever is a public problem in most of the tropical countries of South - East Asia. DHF is a serious form of Dengue Infection, diagnosed on the basis of demonstrating an increased capillary permea-bility and thrombocytopenia with concurrent haemo-concentration. Hess test or Tourniquet test has been recommended as the initial screening procedure of pat-ients with suspected DHF. The objective of the present study was tosee thespecificity of Hess test as a marker of DHF.

Methods:  In a total of 50 patients of DHF admitted to the Mayo hospital Lahore from September to October 2011 during outbreak of Dengue Infection, were pros-pectively studied. Hess test or tourniquet test was con-ducted in these cases in the standard method.

Results:  Out of the 50 patients of DHF, only 26 were Hess test positive. These 50 patients were divided into 4 groups, patients with only rash, only bleeding, bleed-ing and rash together and Non-bleeding Non-rash. Out of 09 patients of rash Hess test was positive in only 06 patients (67.7%). In bleedingonly group Hess test was positive in 06 out of 11 patients (54.5%). Similarly in bleeding n rash simultaneously Hess test was positive in 06 out of 07 patients (85.7%). In non bleeding non rash group Hess test was positive in 08 out of 23 pati-ents (34.8%).

Conclusion:  The tourniquet test was positive in only 52% of all DHF cases. It is concluded that a positive Hess test is a good marker of DHF but negative tourni-quet test may not be sufficient to exclude a diagnosis of DHF in a febrile patient. This necessitates the need for the re-defining the clinical criteria for the diagnosis of DHF, particularly grade I DHF.