"Syndromic approach" to diagnosis and treatment of critical tropical infections.

Sir,

The recent publication on “Management guidelines for tropical fever” is very interesting.[1] According to this publication, a syndromic approach covering “five major clinical syndromes: Undifferentiated fever, fever with rash/thrombocytopenia, fever with acute respiratory distress syndrome, fever with encephalopathy, and fever with multi-organ dysfunction syndrome” was mentioned.[1] The syndromic approach seems to be a useful approach; however, there are some concerns about it. The approach might cover many infections; however, it can underestimate several other conditions. The problems can be seen in cases with atypical clinical presentations, which can lead to missed or delayed diagnosis. In addition, this approach can actually miss the subclinical or asymptomatic cases, which means ineffective management of the possible carriers or reservoir cases.