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Ê
MODE OF
TRA MààO :
Mosquito bite
à CUBATàO PERàOD:
13 to 14 days, following
an acute phase that lasts
for about 5 to 7 days.
m main pathophysiological
changes that occur in DHF
-vascular permeability
-Disorder in hemostasis
h vascular permeability
Hemoconcentration, low
pulse pressure, and
other signs of shock
Disorder in hemostasis
Tourniquet Test
(Rumpel Leads Test)
D7th-1 th day
Dgeneralized flushing
with interventing areas
of blanching appetite
regained strength and
b.p. already stable.
±arning igns for Dengue hock
Alarm Signals:
D evere abdominal pain
D Prolonged vomiting
°our §riteria for DH°: D Abrupt change from
D Fever fever
D Hemorrhagic manifestations to hypothermia
D Excessive capillary D Change in level of
permeability consciousness
D1 , mm3 platelets (irritability
or somnolence)
Initial ±arning Signals:
D Disappearance of ±hen Patients Develop DSS:
fever D 3 to 6 days after onset of
D Drop in platelets symptoms
D àncrease in
hematocrit
§linical §ase Definition for
Dengue Hemorrhagic °ever
@
1. Fever, or recent history of acute fever
m. Hemorrhagic manifestations
3. Low platelet count (1 , mm3 or less)
4. Objective evidence of ³leaky capillaries:´
å elevated hematocrit (m or more over
baseline)
å low albumin
å pleural or other effusions
°our Grades of DH°
È Grade 1
å Fever and nonspecific constitutional symptoms
å Positive tourniquet test is only hemorrhagic
manifestation
È Grade 2
å 'rade 1 manifestations + spontaneous
bleeding
È Grade 3
å igns of circulatory failure (rapidweak pulse,
narrow pulse pressure, hypotension,
coldclammy skin)
È Grade 4
å Profound shock (undetectable pulse and BP)
Danger igns in
Dengue Hemorrhagic Fever