2nd order laboratory parameters – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification.
- DENV RNA – virus detection by PCR (polymerase chain reaction, PCR)* – between the 3rd-7th day of illness.
- Virus cultivation* – between the 3rd – 7th day of illness.
- DENV-NS-1 antigen (the NS1 protein is highly conserved within the four serotypes)In rapid tests for the detection of dengue virus NS1 antigen, variations in sensitivity (percentage of diseased patients in whom the disease is detected by the use of the procedure, i.e., a positive result occurs) are reported between 38% and 71% with a specificity (probability that actually healthy people who do not have the disease in question are also detected as healthy in the test) between 76% and 80%.
- Antibody detection* DENV-specific IgG, IgM – from the 8th day of illness.
- Small blood count* * [mild leukocytopenia/deficiency of leukocytes (white blood cells) and thrombocytopenia/deficiency of platelets (thrombocytes); increase in hematocrit of more than 20% indicates significant extravascular plasma loss → indication for intravenous volume administration to avoid shock syndrome].
- Differential blood count [lymphopenia/deficiency of lymphocytes]
- Inflammatory parameters – CRP (C-reactive protein).
- Electrolytes* * – calcium, chloride, potassium, magnesium, sodium, phosphate.
- Liver parameters – alanine aminotransferase* * (ALT, GPT), aspartate aminotransferase* * (AST, GOT), glutamate dehydrogenase* * (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin [moderate transaminase increase].
- Renal parameters – urea, creatinine* * , cystatin C or creatinine clearance, if necessary.
- Troponin T, creatine kinase* * (CK, CK-MB), lactate dehydrogenase* * (LDH) – due topossible cardiac involvement (heart).
- Coagulation parameters – PTT, Quick
* Mandatory to report in the sense of the Infection Protection Act: the direct or indirect detection of pathogens of virus-induced hemorrhagic fever (report by name!).* * Several control examinations.
