Dengue: Diagnosis and treatment

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Dr.S.D.Shanmugakumar

06 July, 2009

The symptoms of Dengue are high fever with no localising source of infection, a petechial rash with thrombocytopenia and relative leukopenia - low platelet and white blood cell count. To know the detailed account of diagnosis and treatment, read on...

Diagnosis

THE DIAGNOSIS of dengue is usually made clinically. The classic picture is high fever with no localising source of infection, a petechial rash with thrombocytopenia and relative leukopenia - low platelet and white blood cell count. Care has to be taken as diagnosis of DHF can mask end stage liver disease and vice versa.

1.Fever, bladder problem, constant headaches, severe dizziness and loss of appetite.

2.Hemorrhagic tendency (positive tourniquet test, spontaneous bruising, bleeding from mucosa, gingiva, injection sites, etc; vomiting blood or bloody diarrhea)

3.Thrombocytopenia (<100,000 platelets per mm³ or estimated as less than 3 platelets per high power field)

4.Evidence of plasma leakage (hematocrit more than 20 per cent higher than expected or drop in haematocrit of 20 per cent or more from baseline following IV fluid, pleural effusion, ascites, hypoproteinemia)

5.Encephalitic occurrences.

Dengue shock syndrome is defined as dengue hemorrhagic fever plus:

Weak rapid pulse,
Narrow pulse pressure (less than 20 mm Hg)
Cold, clammy skin and restlessness.
Serology and polymerase chain reaction (PCR) studies are available to confirm the diagnosis of dengue if clinically indicated.

Treatment

The mainstay of treatment is timely supportive therapy to tackle shock due to haemoconcentration and bleeding. Close monitoring of vital signs in critical period (between day 2 to day 7 of fever) is vital. Increased oral fluid intake is recommended to prevent dehydration. Supplementation with intravenous fluids may be necessary to prevent dehydration and significant concentration of the blood if the patient is unable to maintain oral intake.

A platelet transfusion is indicated in rare cases if the platelet level drops significantly (below 20,000) or if there is significant bleeding.

The presence of melena may indicate internal gastrointestinal bleeding requiring platelet and/or red blood cell transfusion. Aspirin and non-steroidal anti-inflammatory drugs should be avoided as these drugs may worsen the bleeding tendency associated with some of these infections.

Patients may receive paracetamol preparations to deal with these symptoms if dengue is suspected.

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Commenting System

COMMENTS (6)

sandy

This comment has been removed by the moderator

sadhana

.article is informative but i want to know about the treatment in case of hemorrhagic dengue fever,nothing could be done except blood transfusion?

DR. PARVEZ ALAM PAIKER

This comment has been removed by the moderator

vijay

.TREATMENT FOR DENGUE FEVER-- 1>TAB. OFLOXACIN(OFLOX) 200MG BD 2>TAB. METRONIDAZOLE(METROGYL) 500MG BD 3>TAB. SUMO BD 4>TAB 1-AL 5MG BD TAKE ABOVE 4 TABLETS FOR THREE DAYS TWICE A DAILY, FOR THE TREATMENT OF DENGUE.

sujith

.article is informative but how do paracetamol act in suspected patients in preventing haemorrhage

1 Replies

S.D.Shanmugakumar

Patients are receieving paracetamol preparations, sine it produce mild analgesic effect coupled with anticoagulants

sujith

.article is informative but how do paracetamol act in suspected patients in preventing haemorrhage