Evaluation of the World Health Organization standard tourniquet test
and a modified tourniquet test
in the diagnosis of dengue infection in Vietnam.
Results: Diagnostic accuracy of tourniquet test
for diagnosis of dengue infection in patients with clinically suspected dengue fever, keeping dengue IgM/IgG as gold standard showed 26.88%(95% CI = 20.01- 33.75%) were true positive, 7.5%(95% CI=3.42-11.58%) were false positive, 46.25% (95% CI=38.52-53.98%) were true negative and 19.38% (95% CI =13.26-25.5%) were false negative, whereas sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy was calculated as 58.11%, 86.05%, 78.18%, 70.48%, and 73.12% respectively.
Studies have documented that dengue serology has low specificity and may be falsely negative during the febrile early phase of illness.22,23 Tourniquet test
is recommended for the detection of disease and helps in the early management of DF8 and it was noted that majority of the physicians were performing this test as routine.
In many Asian countries tourniquet test
has been reported in many studies in a study conducted by Qui et al., 1993 in which the tourniquet test
66.9%  was positive and by Halstead studied the clinical features of dengue in Thailand and reported 81% cases were positive for tourniquet test
, while in Puerto Rico it was found 32-31% which is different from the study conducted in Thailand .
During the brachial artery tourniquet test
, an ultrasound probe is placed over the brachial artery, just below the elbow.
We hypothesised that combining tourniquet test
with percussion test (Tinel's Test) increases the specificity and sensitivity of diagnosis of carpal tunnel.
###with only positive tourniquet test
or###: HCT [greater than or equal to]20%
and serial haematocrit were infrequently used.
Low proportion of positive tourniquet test
in our patients may be due to the darker skin color or due to the different strain of dengue virus affecting the Indian subcontinent.
The clinical features in most patients were consistent with signs of DF, but some patients showed signs (high fever, rash, ecchymosis, epistaxis, positive tourniquet test
, liver dysfunction, and thrombocytopenia [platelet count <100,000/m[m.sup.3]]) consistent with the World Health Organization (WHO) definition of DHF.
A positive tourniquet test
petechiae, ecchymoses or purpura bleeding from the mucosa, gastrointestinal tract, injection sites or haematemesis or melaena.