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The test is defined by the WHO as one of the necessary requisites for diagnosis of Dengue fever. A blood pressure cuff is applied and inflated to a point between the systolic and diastolic blood pressures for five minutes. The test is positive if there are more than 20 petechiae per square inch (a petechia is a small red or purple spot on the body, caused by a minor hemorrhage).
This test does not have high specificity. Interfering factors with this test are women who are premenstrual, postmenstrual and not taking hormones, or those with sun damaged skin, since all will have increased capillary fragility.[1]
The Hess test or Rumpel-Leede test is a medical test used to assess capillary fragility.[1] It is also called the Tourniquet test.
To perform the test, pressure is applied to the forearm with a blood pressure cuff inflated to between systolic and diastolic blood pressure for 10 minutes. After removing the cuff, the number of petechiae in a 5cm diameter circle of the area under pressure is counted. Normally less than 15 petechiae are seen.[2] 15 or more petechiae indicate capillary fragility, which occurs due to poor platelet function, bleeding diathesis or thrombocytopenia, and can be seen in cases of scurvy,[3] and Dengue fever.
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