DOC-20250822-WA0014..pdf dengue fever tt

Dengue

1. DENGUE FEVER
Dr.L.SATISH KUMAR
1
st
YEAR PG –Gen Med
RMC, KAKINADA

7. Epidemiologic data were consistent with the belief
that cross-reactive antibodies elicited by the first
dengue infection, unable to neutralize the second virus,
actually potentiate viral entry into cells via antibody-
dependent enhancement for the acute phase

12. The old World Health Organization (WHO) 1997: classification system for dengue,
categorized dengue into Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF),
and Dengue Shock Syndrome (DSS). DF was a non-severe form of the illness,
while DHF involved fever, hemorrhagic manifestations, thrombocytopenia (low
platelet count), and plasma leakage. DSS was defined as DHF with the additional
features of circulatory collapse.

13. The 2009 WHO criteria : classify dengue according to levels
of severity: dengue without warning signs; dengue
with warning signs and severe dengue

14. CLASSIC DENGUE FEVER
DF (also known as “break-bone fever”) is an acute febrile
illness defined by the presence of fever and two or more
of the following but not meeting the criteria of dengue
hemorrhagic fever
•Headache
Retro-orbital or ocular pain
Myalgia and/or bone pain
Arthralgia
Rash
Hemorrhagic manifestations (eg, positive tourniquet
test, petechiae, purpura/ecchymosis, epistaxis, gum
bleeding, blood in emesis, urine, or stool, or vaginal
bleeding)
Leukopenia

15. According to the guidelines, a DHF diagnosis requires all of the 4 to be present

20. POSITIVE TORNIQUE TEST

21. COURSE OF DISEASE:PHASES OF
INFECTION
•FEBRILE PHASE
•CRITICAL PHASE
•RECOVERY PHASE

24. •a small proportion of patients (typically children and young adults)
develop a systemic vascular leak syndrome characterized by plasma
leakage, bleeding, shock, and organ impairment
•So patient may have Tachycardia , narrowing of pulse pressure ( ≤20
mmhg )
•The rise in hematocrit over the baseline indicates severity of plasma
leak.
•Some of the patient’s may develop shock , the warning signs are
Persistent vomiting , severe Abdominal pain , tender hepatomegaly ,
devlopment of effusion,mucosal bleeding
•Progressive shock leads to multi organ failure and disseminated
intravascular coagulation
•And if the patient adequately treated then patient goes to recovery
phase

31. ASCITIS

32. PLEURAL EFFUSION

33. Acalculous Cholecystitis with GB wall edema

35. Patient’s

41. •No specific antiviral therapy – treatment is supportive.
Key is early recognition, careful monitoring, and fluid management.
Avoid drugs that worsen bleeding risk: No NSAIDs, aspirin, ibuprofen → Use only
paracetamol for fever.

62. (SINGLE DONOR PLATELETS)

68. Dengue vaccination is a preventive strategy aimed at reducing the risk
of severe illness and complications from dengue virus infection.
Benefits of Dengue Vaccination
1.Decreases severe diseaseVaccination lowers the risk of dengue
hemorrhagic fever and dengue shock syndrome.
2. Reduces hospitalizations and improves quality of life
3. Protects against multiple serotypes.Some vaccines (like Dengvaxia)
provide protection against all 4 dengue virus types, though
effectiveness varies.
4. Community (herd) protection:Large-scale vaccination reduces
transmission in the community.
VACCINES:

69. The first licensed vaccine (DENGVAXIA) is recommended only for people with
prior dengue infection, since giving it to dengue-naïve individuals may increase
risk of severe dengue on later infection.
Other newer vaccines like TAK-003(QDENGA) are being introduced with fewer
restrictions ( no sero test required before vaccination ).

70. REFERENCES:
•Harrison principles of medicine
•Apurba Sastry textbook of microbiology
•API textbook of Medicine