DENGUE FEVER
Guided by – Dr. Nalamale sir
Dr . Sagre sir
Presented by – Yelale Sumit
. Yelikar Shruti
INTRODUCTION
• From 1950s Dengue has been found mainly in
Asia and Africa , although outbreaks have been
occurred in Cuba and the USA.
• Four different antigenic varieties of the dengue
virus are recognised
• Dengue virus is primarily transmited by Aedes
mosquitoes
MECHANISM
When a mosquito carrying dengue virus bites a
person,
the virus enters the skin together with the
mosquito’s saliva.
• It binds to and enters white blood cells, and
reproduces inside the cells while they move
throughout the body
• In severe infection, the virus production inside
the body is greatly increased, and many more
organs (such as the liver and the bone marrow)
can be affected, and fluid from the
bloodstream leaks through the wall of small
blood vessels into body cavities.
• As a result, less blood circulates in the blood
vessels, and the blood pressure becomes so
low that it cannot supply sufficient blood to
vital organs.
• Furthermore, dysfunction of the bone marrow
leads to reduced numbers of platelets, which
are necessary for effective blood clotting; this
increases the risk of bleeding, the other major
complication of dengue fever
• The course of infection is divided into 3
stages –
•. 1) Febrile phase
•. 2) critical phase
•. 3) Recovery phase
CLINICAL FEATURES --
• Classical dengue fever ( break bone fever )
• 1). Joint pain
• 2). Back pain
• 3) Retro – orbital pain
•. 4). Rashes
CLINICAL FEATURES --
high fever (40°C/104°F)
severe headaches
nausea
• vomiting
If symptoms occur, they usually begin 4-10 days af infection
and last for 2-7 days
CRITICAL PHASE
• The critical phase is the most dangerous stage of
dengue infection. It typically begins after the high
fever subsides. And lasts for 24-48 hours. During
this time. Life-threatening complications can occur
if not closely monitored and treated.
• Possible Complications:
• Dengue Hemorrhagic Fever (DHF)
• Dengue Shock Syndrome (DSS)
DENGUE HEMORRHAGIC FEVER
(DHF)
Hemorrhagic manifestations (e.g.. Skin bruising.
Nosebleeds. Gum bleeding. Blood in vomit or stool)
Low platelet count (thrombocytopenia)
Plasma leakage into surrounding tissues/body cavities
(ascites. Pleural effusion)
Enlargement of the liver
(hepatomegaly)
Can progress to shock if not treated
DENGUE SHOCK SYNDROME
• The most severe form of dengue. Occurring as a
complication of DHF. Where excessive plasma
leakage leads to a sudden drop in blood pressure
(shock). Potentially causing organ failure and
death.
• Key Features --
• Narrow pulse pressure
• Restlessness. Confusion
• Severe hypotension (low blood pressure)
• Poor perfusion to vital organs (kidneys. Brain.
Liver)
DENGUE SHOCK SYNDROME
• DHF + Shock symptoms
•. Narrow pulse pressure ( pp < 20mm Hg )
• pp = systolic pressure - diastolic
pressure
• Restlessness
RECOVERY PHASE
Resorption of the leaked fluid into the
bloodstream
This usually lasts two to three days.
Severe itching and a slow heart rate
• During this stage, a fluid overload state may
occur; if it affects the brain, it may cause a
reduced level of consciousness or seizures.
INVESTIGATIONS OF DIAGNOSIS
1. NS1 antigen test
2. ELISA TEST – IgG and IgM
3. RT PCR – Most sensitive test
4. CXR PA view
5. BTCT
6. USG ( A+P )
Treatment ---
Oral fluids
. IV fluids
No NSIDS
symptomatic treatment
. Criteria for discharge
. 1)absence of fever for 24 hours without use of
antipyretics
. 2) Good urine output
. 3) visible clinical improvement
. 4). Increased platelets count
THANK YOU
