Santos, Raymund John IV- Group E

Dengue (ward class)

Dengue hemorrhagic fever - is a severe, potentially deadly infection spread by certain species of mosquitoes (Aedes
aegypti). Causes, incidence, and risk factors Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person catches a different type dengue virus after being infected by another one sometime before. Prior immunity to a different dengue virus type plays an important role in this severe disease. Symptoms Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. These symptoms are followed by a shock -like state. Bleeding may appear as tiny spots of blood on the skin (petechiae) and larger patches of blood under the skin (ecchymoses). Minor injuries may cause bleeding. Shock may cause death. If the patient survives, recovery begins after a one-day crisis period. Early symptoms include: Decreased appetite Fever Headache Joint aches Malaise Muscle aches Vomiting

Acute phase symptoms include: Restlessness followed by: Ecchymosis Generalized rash Petechiae Worsening of earlier symptoms Shock-like state Cold, clammy extremities Sweatiness (diaphoretic)

the 4 grades of dengue, which are: Grade 1- fever, difficulty in breathing, abnominal pain, rashes. Grade 2- All the symptoms of Grade 1, spontaneous bleeding. Rashes can appear in any grade of dengue. Grade 3- Circulatory failure, weak pulse, bleeding, and low blood pressure Grade 4- Shock and possibly death if the body of the patient is weak and immune system is low. if the dengue enters Stage 3, the patient can suffer from complications like organ failure, central nervous system problem, encephalitis, and others.

Signs and tests A physical examination may reveal: Enlarged liver (hepatomegaly) Low blood pressure Rash Red eyes Red throat Swollen glands Weak, rapid pulse

Tests may include: Arterial blood gases

Coagulation studies Electrolytes Hematocrit Liver enzymes Platelet count Serologic studies (demonstrate antibodies to Dengue viruses) Serum studies from samples taken during acute illness and convalescence (increase in titer to Dengueantigen) Tourniquet test (causes petechiae to form below the tourniquet) X-ray of the chest (may demonstrate pleural effusion)

Treatment Because Dengue hemorrhagic fever is caused by a virus for which there is no known cure or vaccine, the only treatment is to treat the symptoms. A transfusion of fresh blood or platelets can correct bleeding problems Intravenous (IV) fluids and electrolytes are also used to correct electrolyte imbalances Oxygen therapy may be needed to treat abnormally low blood oxygen Rehydration with intravenous (IV) fluids is often necessary to treat dehydration Supportive care in an intensive care unit/environment

Expectations (prognosis) With early and aggressive care, most patients recover from dengue hemorrhagic fever. However, half of untreated patients who go into shock do not survive.

Complications Encephalopathy Liver damage Residual brain damage Seizures Shock

Calling your health care provider

Call your health care provider if you have symptoms of dengue fever and have been in an area where dengue fever is known to occur, especially if you have had dengue fever before.

Prevention There is no vaccine available to prevent dengue fever. Use personal protection such as full-coverage clothing, netting, mosquito repellent containing DEET, and if possible, travel during periods of minimal mosquito activity. Mosquito abatement programs can also reduce the risk of infection.