By ULY CLINIC

Dengue Fever

Dengue is a mosquito-borne viral infection causing by the dengue fever virus, whose full life cycle involves the role of mosquito as a transmitter (or vector) and humans as the main victim and source of infection. Dengue does not spread directly from person to person, it is only spread through the bite of an infected Aedes aegypti mosquito.

Diagnostic Criteria

Dengue Febrile Illness (DF):

Retro-orbital or ocular pain, headache, rash, myalgia, arthralgia,
Hemorrhagic manifestations (e.g., positive tourniquet test, petechiae; purpura/ecchymosis; epistaxis; gum bleeding; blood in vomitus, urine, or stool; or vaginal bleeding,
Anorexia, nausea, abdominal pain, and persistent vomiting may also occur but are not case-defining criteria.

Dengue Hemorrhagic Fever (DHF)

Persistent high grade Fever lasting from 2–7 days
Spontaneous bleeding
Retro-orbital pain
Joint, muscle and abdominal pain
Macular or confluent blanching rash (noted during recovery period)
Thrombocytopenia (>100,000 cells per mm3)

Dengue Shock Syndrome (DSS)

All criteria for DHF plus circulatory failure as evidenced by rapid and weak pulse and narrow pulse pressure (<20mm Hg)
Age-specific hypotension and cold, clammy skin and restlessness

Investigations

Elisa for Dengue NSI antigen
Serological tests: Dengue IgM & IgG Rapid Strip Test.
FBP

Non-Pharmacological Treatment

No specific treatment is available for Dengue fever.

Pharmacological Treatment:

Paracetamol 15mg/kg 8 hourly for 3 days
Maintainance fluid (Ringers lactate, NS) intravenously if child cannot take enough orally
Blood transfusion and clotting factors.
Oxygen and manage hypoglycaemia if present

Note:

No antibiotics are of proven value.
Children below 12 years require close monitoring for dangerous form.
Avoid Aspirin and other NSAIDs.
Steroids should not be used.

Updated on, 28.10.2020

References

1. STG page number 10-12

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