A 26-year-old woman with dengue fever has platelet count 22,000/μL on day 5 but no mucosal bleeding, no petechiae beyond a few scattered lesions, stable haematocrit, normal blood pressure, and no warning signs. She is haemodynamically well on oral fluids. What is the correct classification and approach?

• A Severe dengue, requires immediate platelet transfusion
• B Dengue without warning signs, managed with close monitoring and oral fluids ✓
• C Dengue with warning signs, requires prophylactic platelet transfusion
• D Dengue with warning signs, requires crystalloid bolus therapy

Explanation

Under the WHO 2009 classification, isolated thrombocytopenia without bleeding, plasma leakage, shock, or organ impairment is dengue without warning signs. Platelet count alone does not trigger transfusion; prophylactic platelet transfusion is not recommended and is reserved for significant bleeding or very low counts with high bleeding risk. Fluid boluses are reserved for shock, which this patient does not have.

Reference: WHO Guidelines for Diagnosis, Treatment, Prevention and Control of Dengue, 2009 ed.

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Written and medically reviewed by the StethoPrep medical team.