Dengue fever is a mosquito-borne illness that can be life-threatening. The course follows 3 phases: the febrile phase, which lasts about 2 to 7 days, and when minor hemorrhagic manifestations may occur; the critical phase, which lasts about 24 to 48 hours, and when plasma leakage can progress to shock, hemorrhage, and death; and the convalescent phase, when stabilization occurs (CDC, 2024).

How to Perform the Tourniquet Test

Minor hemorrhagic manifestations that may occur during the febrile phase include petechia, ecchymosis, purpura, epistaxis, gingival bleeding, hematuria, or a positive tourniquet test result. The tourniquet test is a marker of capillary fragility used as a triage tool for dengue fever (CDC, 2018).

To perform the tourniquet test:
1. Take the patient's blood pressure and record it.
2. Then, inflate the cuff to a point midway between SBP and DBP and maintain it for 5 minutes.
3. Next, reduce the pressure and wait 2 minutes.
4. Count the petechiae below the antecubital fossa.

A positive test is 10 or more petechiae per 1 square inch.
 

References:

Centers for Disease Control and Prevention (CDC). (2024, June 5). Clinical Features of Dengue. CDC. https://www.cdc.gov/dengue/hcp/clinical-signs/index.html

Centers for Disease Control and Prevention (CDC). (2018, July). Dengue Clinical Case Management (DCCM). CDC. https://www.cdc.gov/dengue/training/cme/ccm/index.html

 

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