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Dengue / Dengue Hemorrhagic Fever

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Dengue and dengue hemorrhagic fever (DHF) is an arbovirus disease of the Genus Flavivirus.

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The disease is caused by one of four closely related, but antigenically distinct, virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4).

Due to serotype specificity infection with one serotype does not provide cross-protective immunity to other serotype, so persons are theoretically susceptible to have four dengue infections during their lifetime.

Dengue viruses are transmitted from person to person by a domestic mosquito called - Aedes aegypti.

Infection with dengue viruses causes clinical illness ranging from a less dangerous non-specific viral syndrome called 'Dengue fever' to severe and fatal hemorrhagic disease of 'Dengue Hemorrhagic Fever (DHF)'.

Dengue Fever

The severity and risk factors for DHF depends upon:

  • Strain and serotype of the infecting virus
  • Age
  • Immune status
  • Genetic predisposition of the patient. Dengue Hemorrhagic Fever (DHF) is the most severe form of dengue, which can be fatal if unrecognized and not properly treated; DHF is caused by infection with the same viruses that cause dengue.

Latest Publications and Research on Dengue / Dengue Hemorrhagic Fever

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Do you wish to consult a General Medicine Doctor / Internal Medicine Doctor for your problem? Ask your question

Dr. Keerthanaraj P
Dr. Keerthanaraj P
MBBS
3 years experience
Communicable Disease Hospital, Anna nagar, Chennai
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Comments

yousufmohammad

please inform if age is 54 women, High blood pressure and chronic disease, She has Fever and body pain.She is in ICU for three days.is it advised to get her discharged.Platelet count 1 lac. How severe dengue can be in her condition?
As my Mother in ICU>Please Reply

Awaami

Dear Yousaf,with Hypertension,another chronic disease,and age above 50,the afebrile period is significant,the patient should be advised about the warning signs for plasma leakaga,i.e, the reduced BP,or reduced pulse pressure[the difference between the upper-systolic and lower-diastolic one,e.g. if it comes down to 100/90.the increased capillary refilling time, the tender liver,and or hemmhorages,reduced urinary output,blood in vomiting,altered mentation,increasing respiratory disconfort. All these may indicate her transition towards shock,which is actually far more important than platelts,particularly in absence of internal or external bleeding . Observe your patient for all this,and then decide about discharge. Regards . P-dopp Peoples Doctors @ facebook.

Tewari55

The platelet count is not the only important determinant of bleeding.


Indications for blood/platelet transfusion as recommended in clinical practice guidelines are:

In cases with significant clinical bleeding, which require blood transfusion. Usually bleeding is > 10% of total blood volume (> 6-8 ml/kg of ideal body weight)
In adults with underlying hypertension or coronary heart diseases and platelet 1.3-1.5, which is the result of liver failure: Major contributing factor for massive bleeding.
There is no evidence to support the use of blood components such as platelet concentrates, fresh frozen plasma or cryoprecipitate. Its use could contribute to fluid overload.

Important instructions for treatment of DHF as per WHO/SEARO guidelines:

If the patient’s condition becomes worse despite giving 20ml/kg/hr crystalloid solution for one hour, replace crystalloid solution with colloid solution such as Dextran or Plasma. As soon as improvement occurs, replace with crystalloid.


In case of severe bleeding; give blood transfusion @ 20ml/kg for two hours. Then give crystalloid IV fluids @ 10 ml/kg/hr for a short time (30 - 60 minutes) and later reduce the speed.


If hematocrit falls, give blood transfusion 10 ml/kg and then give crystalloid IV fluids at the rate of 10 ml/kg/hr. The volume of blood administered should be just enough to raise the red blood cell concentration to normal.

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