Dengue infection is caused by any of four serotypes of dengue virus . The virus is spread by the bite of mosquito named Ades Egypti.
The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagic fever (DHF). DHF is characterized by continuous high fever for 2–7 days; bleeding manifestations such as petechiae (pin head size bleeding spots), epistaxis (bleeding from nose) and haematemesis (blood in vomitus or black vomitus); thrombocytopenia with platelet counts <100 x 10 base9 / L and plasma leakage due to increased vascular permeability evidenced by hemoconcentration, pleural effusion and ascites. Bleeding manifestations caused by vasculopathy (blood vessels damage), thrombocytopenia (low platelet count), platelet dysfunction (poor platelet function) and coagulopathy (coagulation factors defect).
The three stages of clinical presentations are classified as febrile, toxic and convalescent. The toxic stage, which lasts 24–48 hours, is the most critical period, with rapid plasma leakage leading to circulatory disturbance. The severity of DHF varies from mild (World Health Organization grades I and II), with minimal and transient change in vital signs, to severe (World Health Organization grades III and IV), with threatened shock (e.g. blood pressure 100/90 mmHg) or profound shock.
There is no specific treatment for DHF.
- Intensive supportive care is the most important aspect of management.
- Early recognition of the disease and careful monitoring for circulatory disturbance are essential.
- Optimal fluid therapy to maintain the functions of the vital organs during the critical period.
- Effective control of bleeding episodes will lead to favorable outcomes.
- Administration of recombinant activated factor VII is suggested whenever massive bleeding does not respond to blood component therapy.
What NIBD can do for your Dengue fever patient?
NIBD is a centre exclusively made for the management of blood and blood related disorders. DF is not a direct blood disorder but somehow, some of these patients developed haematological manifestations in a form of low platelet count, platelet poor function and coagulation factors defect. These abnormalities results in bleeding manifestations. These complications could be life threatening if not managed promptly and timely.
NIBD has all facilities round the clock (24 x 7) to managed these patients in terms of
- Consultation from Doctor
- Laboratory diagnosis
- Hospital admission
- Timely availability of random/ mega unit of platelets
- ICU care if required
- Recombinant Fact VIIa (if required)