Review of the role of ultrasound in assessing plasma leakage in dengue fever and a proposed scanning protocol

Abstract

Background: The clinical course of dengue can range from mild to severe and predicting the course can be challenging. The World Health Organisation (WHO) recommends prognostication via the presence of warning signs, to aid in disposition and management. Plasma leakage is a key warning sign in dengue, and ultrasound can be utilised as a screening tool. Objectives: The objectives were to describe the literature on the use of ultrasound in dengue, summarise the findings, and propose a standardised point-of-care ultrasound protocol. Methods: We reviewed the current literature on the role of ultrasound in dengue and its key features. Results: Ultrasound is a useful tool in the evaluation of patients with dengue and has been shown to be able to detect plasma leakage even prior to clinical and laboratory findings. In particular, gallbladder wall thickening is an early sign that can aid the clinician in prognosticating patients. Conclusion: Detecting plasma leakage early with ultrasonography can help the clinician determine appropriate disposition and management. We propose a standardised point-of-care ultrasound protocol (FASD) for early detection of plasma leakage in dengue, in the routine care of dengue patients.