You are on page 1of 11

DENGUE HEMORRHAGIC FEVER

 Nurlaili Mahpuzoh P37320117027


 Ridho Hafiurrahman P373201170
 Rina Rizki Hasibuan P373201170
 Syahriani Fitri Siagian P373201170
 Verena Ribka P373201170
Definition of Dengue hemorrhagic
fever (DHF)
• A syndrome due to the dengue virus that tends to affect children under 10,
causing abdominal pain, hemorrhage (bleeding) and circulatory collapse (shock). DHF
starts abruptly with high continuous fever and headache plus respiratory and intestinal
symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs
after 2 to 6 days with sudden collapse, cool clammy extremities, weak thready pulse, and
blueness around the mouth (circumoral cyanosis).
• There is bleeding with easy bruising, blood spots in the skin (petechiae), spitting up blood
(hematemesis), blood in the stool (melena), bleeding gums and nosebleeds
(epistaxis). Pneumonia and heart inflammation (myocarditis) may be present. The mortality is
appreciable ranging from 6 to 30%. Most deaths occur in children. Infants under a year of age
are especially at risk of death.
Causes of dengue fever
• Dengue is caused by one of four dengue
viruses (dengue virus types 1-4 or DENV
1-4) that are transmitted by the bite of an
infected Aedes aegypti mosquito that has
previously bitten an infected person. In the
Western Hemisphere, the Aedes aegypti
mosquito is the most common transmitter
of dengue infection; transmission by the
Aedes albopictus mosquito bite has also
been reported.
Symptoms & Signs
• Primary symptoms of dengue appear three to 15 days after the
mosquito bite and include high fever and severe headache, with severe
pain behind the eyes that is apparent when trying to move the eyes.
Other associated symptoms are joint pain, muscle and bone pain, rash,
and mild bleeding. Many affected people complain of low back pain.
The lymph nodes of the neck and groin may be swollen. Young children
and people infected for the first time typically have milder symptoms
than older children and adults.
• Dengue hemorrhagic fever starts with the typical signs and symptoms
of dengue as described above. The fever lasts from two to seven days.
symptoms occur that are related to increased permeability of the
capillary blood vessels. These symptoms can include severe abdominal
pain, prolonged vomiting, and breathing problems. Bleeding
tendencies, including easybruising, nosebleeds, bleeding gums, skin
hemorrhages, and even internal bleeding may occur. The disease may
progress to failure of the circulatory system, leading to shock and
death.
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 Dengue Haemorrhagic Fever
(DHF) can mask end stage liver disease and vice versa. If one has persistent fever for more that 2
days then one should go for a complete blood checkup (CBC). If the platelet count and WBC count
are below than their usual range one should go for Dengue Antigen test.

Dengue is always a diagnosis of exclusion, and other diseases with the same initial clinical
presentation must be suspected. In order to help the clinician in the detection of severe forms of
dengue (DHF/DSS), even when the definitive diagnosis has not been made yet, the following three
essential laboratory tests may help in the evaluation of the real clinical conditions of the patient and
its early supportive management:
Advanced . . . . .
• Total White Blood Cells Count: In case of dengue, this test will reveal leukopenia. The presence of
leukocytosis and neutrophilia excludes the possibility of dengue and bacterial infections
(leptospirosis, meningoencephalitis, septicemy, pielonephritis etc.) must be considered.
• Thrombocytopenia (less than 100.000 per mm3): Total platelets count must be obtained in every
patient with symptoms suggestive of dengue for three or more days of presentation. Leptospirosis,
measles, rubella, meningococcemia and septicemy may also course with thrombocytopenia
• Hematocrit (micro-hematocrit): According to the definition of DHF, it’s necessary the presence of
hemoconcentration (hematocrit elevated by more than 20%); when it’s not possible to know the
previous value of hematocrit, we must regard as significantly elevated the results more than 45%.
Medication of DHF
• Medication Summary
• No specific antiviral medication is currently available to treat dengue. The treatment of
dengue fever is symptomatic and supportive in nature. Bed rest and mild analgesic-
antipyretic therapy are often helpful in relieving lethargy, malaise, and fever
associated with the disease. Acetaminophen (paracetamol) is recommended for
treatment of pain and fever. Aspirin, other salicylates, and nonsteroidal anti-
inflammatory drugs (NSAIDs) should be avoided.
• Patients with dengue hemorrhagic fever or dengue shock syndrome may require
intravenous volume replacement. Plasma volume expanders can be used in patients
who do not respond to isotonic fluids
Thanks for the attention guysss

You might also like