An urgent echocardiogram showed global hypokinesia, with an ejection fraction of 40%. Severe dengue occurs as a result of secondary infection with a different virus serotype. Repeat platelet count was 22,000mm 3 and the hematocrit 48%. Management of dengue haemorrhagic feverldengue shock syndrome. The most important feature of severe dengue is increased capillary permeability leading to dengue shock syndrome dss.
Dengue haemorrhagic fever dhf and shock syndrome dss. As the disease spreads to new geographical areas, the frequency of the outbreaks is increasing along with a changing disease epidemiology. Dengue hemorrhagic fever and dengue shock syndrome some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and sometimes fatal form of the. Pathophysiology and management of dengue hemorrhagic fever. This deterioration occurs at the time of, or shortly after, the fall in temperaturebetween the third and the seventh day of the disease. Dengue is not included in the generic integrated management of childhood illness imci algorithm, but due to its importance, it was incorporated in several asian and latin american imci adaptations. Dengue is a mosquitoborne disease caused by any one of four closely related dengue viruses denv1, 2, 3, and 4. Ctso, highlights the first successful treatment of dengue shock syndrome caused by dengue virus infection. Pdf alternate hypothesis on the pathogenesis of dengue. Pathogenesis of dengue haemorrhagic fever and its impact on. When shock becomes established, mortality rates of 10% have been reported, although they can be less than 1% when patients are looked after by experienced clinical teams. What is the definition of dengue shock syndrome medical.
Risk factors associated with development of dengue. The only known effective treatment in dss is timely and aggressive fluid resuscitation. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever dhf, and eventually dengue shock syndrome dss. May 03, 2019 the distribution of dengue is geographically determined. Known also as dengue hemorrhagic fever dhf, it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat. Dengue shock syndrome caused most of 14 deaths manila.
Rommel lizan, md is currently a government physician at city health office malabon city. Blood test predicts kids at risk for dengue shock syndrome. Studies on the pathophysiology of dengue haemorrhagic fever and dengue shock syndrome. Dengue presents with spectrum of clinical manifestations, ranging from asymptomatic, undifferentiated mild fever, dengue fever df, to. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Infection with one serotype of denv provides immunity to that. First successful treatment of dengue fever and dengue shock.
Dss is characterized by a massive increase in systemic capillary permeability with consequent hypovolemia. The dengue virus is a single stranded, positivesense rna virus approximately 11 kb in length. Age and sex both are affected since dengue is a universal infection season aedes aegypti is more commonly found in tropical and subtropical countries. Other articles where dengue shock syndrome is discussed. Current and historical conditions indexed list of current and historical nationally notifiable conditions. Dengue shock syndrome definition of dengue shock syndrome. Duque explained that the dengue shock syndrome is a grade four classification, according to the world health organization.
What is dengue hemorrhagic fever and dengue shock syndrome. Alternate hypothesis on the pathogenesis of dengue hemorrhagic fever dhfdengue shock syndrome dss in dengue virus infection may 2008 experimental biology and medicine 2334. Jan 15, 2001 dengue hemorrhagic fever is an important cause of morbidity among asian children, and the more severe dengue shock syndrome dss causes a significant number of childhood deaths. Studies on the pathophysiology of dengue haemorrhagic.
The unusual manifestations may be underreported or unrecognized or not related to dengue. Two theories have been proposed to explain the pathophysiology of dhfdss. Learn more dengue clinical case management elearning pathophysiology of severe dengue. Dengue fever remedy pawpaw papaya leaf juice is a natural cure for dengue fever remedy. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. Objectives early diagnosis pathophysiology of dhf proper management how to avoid complications case 07may18 ples slcp 2.
Dengue shock syndrome the condition of patients who progress to shock suddenly deteriorates after a fever of 27 days duration. Dengue virus infections are a major cause of morbidity and mortality in tropical and subtropical areas of the world. National center for emerging and zoonotic infectious diseases. Dengue fever has emerged as a global public health problem in the recent decades. Dengue shock syndrome symptoms, causes, diagnosis, and treatment information for dengue shock syndrome dengue fever with alternative diagnoses, fulltext book chapters, misdiagnosis, research treatments, prevention, and prognosis. These serotypes are members of the flavivirus genus, which also contains the viruses that cause yellow fever, and can occur in any country where. Antibodydependent enhancement of disease and severe dengue. Department of health and human services centers for. Dengue shock syndrome dss is defined as hypotension, narrow pulse. A syndrome due to the dengue virus that tends to affect children under 10, causing abdominal pain, hemorrhage bleeding and circulatory collapse shock. Focusing on the serious form of dengue, the forms with overt bleeding dengue hemorrhagic fever and shock dengue shock syndrome are classified as dengue with high severity. Menurut kriteria who tahun 1997 dinyatakan sebagai dhf derajat iiiiv. Dengue shock syndrome an overview sciencedirect topics.
Clean the leaves and pound and squeeze with a filter cloth. So, take two 2 tablespoons of pawpaw papaya leaf juice once a day. Dengue is the most important mosquitotransmitted viral disease in terms of morbidity and mortality dengue is a homonym for the african ki denga pepo. Etiology vector mosquito primarily aedes aegypti most female ae. Some african and haitian data demonstrate a relative dearth of dengue hemorrhagic fever and dengue shock syndrome during dengue fever epidemics, suggesting that these populations may share a genetic advantage to the virus. Dengue and dengue hemorrhagic fever dengue shock syndrome. You will only get one tablespoon of juice per leaf. Studies on the pathophysiology of dengue haemorrhagic fever. Based on a clinical diagnosis of dengue shock syndrome dss plus. In the past 30 years, dengue transmission and the frequency of dengue epidemics have increased greatly in most tropical countries in the american region. Since 1968 dengue virus infection has been found in indonesia, especially at surabaya and jakarta city. The illness often begins with a sudden rise in temperature accompanied by facial flush and other flulike symptoms. Alternate hypothesis on the pathogenesis of dengue hemorrhagic fever dhf dengue shock syndrome dss in dengue virus infection may 2008 experimental biology and medicine 2334. May 03, 2019 in 2030% of dhf cases, the patient develops shock, known as the dengue shock syndrome dss.
Immunopathologic mechanisms of dengue hemorrhagic fever and. Viral virulence, infection enhancing antibodies, cytokines and chemical mediators in the setting of intense immune activation are the key players implicated in the pathogenesis of dhf. The mainstay of treatment is prompt, vigorous fluid resuscitation 911. Dengue fever,dengue shock syndrome linkedin slideshare.
It is predominant in tropical and subtropical zones but its geographical distribution is progressively expanding, making it an escalating global health problem of today. Dengue haemorrhagic fever dhf is a potentially deadly complication with symptoms similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. Based on a clinical diagnosis of dengue shock syndrome dss plus myocarditis, dobutamine and noradrenaline infusions were started. He frequently answers questions regarding dengue fever, hemorrhagic fever, rabies and. Role of cognitive parameters in dengue hemorrhagic fever and. This is the part of the blood that is first to come out of the blood vessels. Some forms can lead to fatal complications such as dengue shock syndrome. The most widely cited hypothesis for this occurrence is antibody dependent enhancement ade of.
Dengue hemorrhagic fever is a severe, often fatal, febrile disease caused by dengue viruses. Dengue virus can either cause dengue fever, dengue hemorrhagic fever or dengue shock syndrome due to the antibodydependent enhancement chew et al. Worldwide, children younger than 15 years make up 90% of dhf cases. Clinical and laboratory features, progress and outcome of these patients were analysed in order to identify risk factors associated with development of dengue haemorrhagic fever dhf and dengue shock syndrome dss. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Dengue, dengue haemorrhagic fever and dengue shock. Clinical and laboratory characteristics of dengue shock syndrome in children complied with current who guidelines as markers of severe disease and presented variables to. Symptoms typically begin three to fourteen days after infection. Aedes aegypti is the major vector for transmission of dengue virus in lahore, pakistan.
Plasma leakage and intrinsic coagulopathy are the pathological hall marks in dengue haemorrhagic fever dhf. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a critical need for adequate tropism assays, animal models, and human autopsy data. Fluids were given with caution, and fresh frozen plasma ffp and platelet transfusion was commenced. However, it is essential that proper clinical assessment is carried out for. Dengue is an important differential diagnosis of fever in children presenting to firstlevel health facilities in tropical asia and latin america. Dengue shock syndrome dss adalah sindrom syok yang terjadi pada penderita dengue hemorhagic fever dhf atau demam berdarah dengue. Severe dengue most commonly occurs among infants and patients with secondary dengue virus denv infections i. Dengue is becoming recognized as one of the most important vectorborne human diseases. The acute abdominal complications of dengue fever are acute appendicitis, acute pancreatitis, acute acalculous cholecystitis and nonspecific. Characteristics of dengue shock syndrome match who markers. Guidelines for treatment of dengue feverdengue hemorrhagic fever in small.
If appropriate volume resuscitation is started at an early stage, shock is usually reversible. Jul 15, 2009 shock syndrome is a dangerous complication of dengue infection and is associated with high mortality. Increased vascular permeability, together with myocardial dysfunction. Jun 09, 2016 dengue shock syndrome is the fourth clinical syndrome of dengue fever a sever form of dengue hemorrhagic fever 4 criteria for dhf evidence of circulatory failure manifested indirectly by all of the following. Rapid and weak pulse narrow pulse pressure of current and historical nationally notifiable conditions. Ctso, highlights the first successful treatment of dengue shock syndrome caused by. Clinical and serologic study of cuban children with dengue hemorrhagic feverdengue shock syndrome dhfdss. Sep 17, 2010 dengue shock syndrome who 1997 all the above 4 criteria for dhf, plus evidence of circulatory failure. The immunopathological mechanisms that result in severe complications of dengue virus infection, i. Jul 10, 2012 rommel lizan, md is currently a government physician at city health office malabon city. Considered as major human arbovirosis, dengue occurs in several clinical forms. The most urgent consideration is to establish intravenous access even though this can be difficult in a patient with poor peripheral circulation. He frequently answers questions regarding dengue fever, hemorrhagic fever, rabies and the traditional tandok.
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