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By
Dr Raksha Bhat
Moderated by
Dr Shalini Shenoy
OVERVIEW
CASE
Background
Transmission
Virus morphology
Viral replication and pathogenesis
Host immune response
OVERVIEW
Personal history:
No history of tobacco or alcohol abuse
Non smoker
Non vegeterian diet
Family history:
Six members, no similar complaints
among them
No significant history
Pallor: Present
Icterus: Absent
Cyanosis: Absent
Clubbing: Absent
Lymphedanopathy: Absent
Edema: Absent
Clinical examination continued…
Weight: 56 kgs
Temperature: 102˚F
Filaria Negative
Dengue Ig M ELISA POSITIVE >53.76 Panbio
units ( >11 positive)
Direct 78 45
Count 21 52 [Not investigated]
01 02
00 01
Platelet 30000 31000 40000 67000 90000
Count
Investigation DAY 6 13/8 DAY 7 14/8 DAY 8 15/8 DAY 9 16/8
Direct
Count
[Not investigated]
PLATELET COUNT
250000
200000
150000
100000
50000
0
DAY 1 DAY 2 DAY 3 DAY 4 DAY 5 DAY 6 DAY 7 DAY 8 DAY 9
FEVER
100.5
100
99.5
99
98.5
98
97.5
DAY 1 DAY 2 DAY 3 DAY 4 DAY 5 DAY 6 DAY 7 DAY 8 DAY 9
The patient responded well to treatment
and symptomatically improved.
Platelet count, hematocrit improved and
body temperature reached normal
‘DENGUE FEVER’
Follow up:
The patient visited the outpatient
department a week later, he had no fresh
complaints.
Follow up investigations were done:
Investigation Report Normal range
Haemoglobin 11.7 12-16
Haematocrit 41.3 40-55
Total WBC Count 5000 4000-10000
Direct N 67 50-70
Count L 28 20-40
M 01 0-10
E 00 0-10
Background:
Arthropod borne flavi virus infection
Dengue
Asymptomatic Dengue Haemorrhagic
infection fever fever/ Dengue
Shock Syndrome
25000 CASES
20000
169
15000 96
28292
80
10000 18860 70
15535
69 12561
5000 8693
5534
0
2007 2008 2009 2010 2011 2012
Ig M based assays
Ig G based assays
Antigen detection
Serological tests