Day of Fever Presentation Patho- Clinical Supportive Treatment Results with

physiology presentation laboratory findings or without

complications
0-14 incubation period None
Day 1 -3 Fever,headache,aches&pain Vi raemia Chills and Take baseline esp. paracetamol
rigors Haematocrit;platelet
count
Day 4 Fever may drop suddenly, Immune Abdominal Haematocrit Encourage
but still ill,lethargic reaction pain, Cold & increases from fluids. IV line for Early warning
starts. clammy baseline. normal signs appear.
Stage of extremities, May not see change maintainence Entering
vasodilatation Erythematous in platelet count. infusion stage of
flushing of hypovolemia
skin, low Take baseline LFT No bleeding
pulse volume, esp. Transaminase yet.
Narrow pulse REVERSIBLE
pressure STAGE
Day 5&6 Fever may rise again. Ongoing As above, Haematocrit high. Require Bolus
Patient still ill, lethargic. immune with little or Platelet counts fall infusions to Recovery
This stage may last reaction. no evidence from baseline. May maintain stage.
from 2-3 days. Vasodilitation microvascular be considered low. vascular Dengue with
Classical Dengue bleeds on volume. Second little or no
/Dengue without mucosal Transaminase levels drip line for this. warning
complications surfaces increase. signs.
Variations in pulse Classical
and blood pressure Dengue
+/-
IgM and Dengue
PRP positive
Day 7-8 Fever falls gradually. Can be Stage of May still have Haematocrit Be careful of May see
RECOVERY encouraged to drink immune abdominal stabilizes. bolus fluid Islands of
reaction but pain Platelet count shows infusions. white in sea
peak activity Epigastric no change . Maintain of red.
 dropped. tenderness. Stationary. maintainence Can go home
Liver may be drip and adjust if results are
palpable and accordingly stable. If drip
tender is not taken
care of can
develop
effusions
Day 5&6 Ongoing May still have Haematoctit Dengue with
Critical stage may last Fever may rise again. immune abdominal fluctuates with warning
from 2-3 days. Patient still ill, lethargic. reaction. pain volume May require signs.
Or May be restless. Abdomen Vasodilitation Epigastric replacement. macromolecular Dangers- -
Dengue Fever with may appear full or early with tenderness. Platelet count can
infusions/ initially
Complications/Dengue distension with pain in increasing Liver may be have drastic falls
plasma or fresh hypovolemic
Shock Syndrome epigastrium and vasculitis palpable and blood according shock now
hypochondrium tender. May Blood pressure may
to rapid fall in with wide
tenderness. see some fall with low volume
haematocrit, spread
petecheae on pulse may be rapid blood pressure mucosal
skin & and tready and platelet bleeding
mucosal count. .IMPENDING
surface. SHOCK /or
Bruises and SHOCK
ecchymosis at
injection
sites.
DSS or In recovery : Effusions. GI Bleeding or bleeding into vital organs such as heart lungs and CNS
Encephalitis (rare)
Complications of Transaminitis common in older age groups with sero reactive manifestations such as joint pains and SLE,RA
dengue: manifestations .
Dengue can reoccur as there is no cross immunity between the types.(1.II,III and IV)