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    Dengue Fever Pathophysiology and Its Management

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    Teresita Aviles
    Dengue fever is caused by a flavivirus transmitted through the bites of infected Aedes aegypti mosquitoes. It has an incubation period of 3-14 days. The disease ranges from a mild fever to severe dengue hemorrhagic fever characterized by bleeding, low platelet counts and plasma leakage. Diagnosis is based on clinical findings and confirmed with blood tests showing thrombocytopenia and elevated hematocrit. Treatment involves fluid replacement and hospitalization for severe cases. Prevention focuses on eliminating mosquito breeding sites and using barriers to prevent bites.

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    Dengue Fever Pathophysiology and Its Management

    Uploaded by

    Teresita Aviles
    28 views2 pages
    Dengue fever is caused by a flavivirus transmitted through the bites of infected Aedes aegypti mosquitoes. It has an incubation period of 3-14 days. The disease ranges from a mild fever to severe dengue hemorrhagic fever characterized by bleeding, low platelet counts and plasma leakage. Diagnosis is based on clinical findings and confirmed with blood tests showing thrombocytopenia and elevated hematocrit. Treatment involves fluid replacement and hospitalization for severe cases. Prevention focuses on eliminating mosquito breeding sites and using barriers to prevent bites.

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    Dengue Fever Pathophysiology and its Management

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    Dengue fever is caused by a flavivirus transmitted through the bites of infected Aedes aegypti mosquitoes. It has an incubation period of 3-14 days. The disease ranges from a mild fever to severe dengue hemorrhagic fever characterized by bleeding, low platelet counts and plasma leakage. Diagnosis is based on clinical findings and confirmed with blood tests showing thrombocytopenia and elevated hematocrit. Treatment involves fluid replacement and hospitalization for severe cases. Prevention focuses on eliminating mosquito breeding sites and using barriers to prevent bites.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    28 views2 pages

    Dengue Fever Pathophysiology and Its Management

    Uploaded by

    Teresita Aviles
    Dengue fever is caused by a flavivirus transmitted through the bites of infected Aedes aegypti mosquitoes. It has an incubation period of 3-14 days. The disease ranges from a mild fever to severe dengue hemorrhagic fever characterized by bleeding, low platelet counts and plasma leakage. Diagnosis is based on clinical findings and confirmed with blood tests showing thrombocytopenia and elevated hematocrit. Treatment involves fluid replacement and hospitalization for severe cases. Prevention focuses on eliminating mosquito breeding sites and using barriers to prevent bites.

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    © All Rights Reserved
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    DENGUE FEVER  Elevated hematocrit (20% or more

    - Also called as breakbone fever, dandy fever, over baseline)


    hemorrhagic fever  d/t plasma leaking in the
    - Thrombocytopenic purpura interstitial space
    o Thrombocytes are low >> bleeding  Low albumin
     D/t injury > histamine ᛏ
    INFECTIOUS AGENT capillary permeability >
     Flavivirus fluid (where albumin is)
    goes out to interstitial
    INCUBATION PERIOD space = edema
     3 – 14 days; commonly 7 – 10 days  Pleural or other effusions (edema)

    MODE OF TRANSMISSION HEMMORRHAGIC FEVER


     Bite of an infected mosquito (Aedes aegypti)  There is infection/injury to the tissues > ᛏ capillary
    permeability > plasma (rich in albumin) leakage to
    PERIOD OF COMMUNICABILITY the interstitial space >> (edema) >> lessens
     A day before the febrile period to the end of it circulating blood volume >> hypovolemia > shock
     Mosquito becomes infective from day 8 – 12 after
    the blood meal and remains infective throughout its 2 Pathophysiological Changes:
    life  Increased vascular permeability
     Disorder in hemostasis > ᛎ thrombocytes
    AEDES AEGYPTI
    - Tiger mosquito GRADING OF DHF
    - Only female feeds on human blood because they GRADE I
    need the protein found in the blood to produce eggs - The only hemorrhagic manifestation is a positive
    (Male feed only on plant nectar) tourniquet test
    - Lifespan: 14 – 21 days GRADE II
    - Breed in warm humid weather and stagnant water - Patients with spontaneous bleeding
    - Characteristics: GRADE III
    o Black and white stripes - Circulatory failure manifestation
    o Bites during daytime (DAYBITERS) GRADE IV
     1 – 2 hours after sunrise - Profound shock
     1 – 2 hours before sunset
    o Lay its egg in clean, stagnant water
    CRITERIA FOR DENGUE SHOCK:
     Can lead to hemorrhagic fever  Increased vital signs
    o Bleeding – thrombocytes/platelets, RBC,  Clammy skin
    hemoglobin, hematocrit o Plasma leakage > ᛎ circulating blood
    o Low levels of blood platelets volume > SNS is stimulated > adrenal
     Below 50,000 >> bleeding internally medulla > NE > vasoconstriction > blood
     Normal platelet count: 150,000 – being directed to primary organ (brain)
    400,000/microliter of blood  Altered mental status d/t ᛎ in circulating blood going
    o Blood plasma leakage (goes into interstitial to brain
    space) > bec. there is injury  Frank shock
    o Dengue shock syndrome > low blood pressure
    occurs
    LABORATORY TESTS:
    4 NECESSARY CRITERIA DHF:  Complete blood checkup
     Fever for 2 – 7 days o Platelets (ᛎ)
     Hemorrhagic manifestations at least one o Hematocrit (ᛏ)
    o Bleeding of the gums, nose, bruises  Albumin (ᛎ)
    o (+) tourniquet test (Rumple Lead Test)  Liver function test (AST and ALT ᛏ)
    o Petechiae  Urine test for bleeding
    o Ecchymosis  Tourniquet test
    o Musocal/GI bleeding
    o Low platelet count (100,000/mm3 or less)
    o Leaky capillaries
    HOW TO DO TOURNIQUET TEST?
     Inflate the BP cuff up to the midpoint of the patient’s
    blood pressure. (or use tourniquet)
     Release the cuff after 5 minutes
     If there are more than 20 petechiae per square inch,
    patient is positive of dengue fever

    MANIFESTATIONS OF DENGUE FEVER


     Fever
     Itchy
     Skin rashes

    SIGNS AND SYMTPOMS OF HEMORRHAGIC FEVER


     Vomiting
     Bruises easily d/t ᛎ thrombocytes
     Epistaxis, gum bleeding (d/t low platelet count)
     Rapid pulse (compensation)
     Narrow pulse pressure

    MANAGEMENT
     Fluid replacement (home treatment)
     If there’s hemorrhagic manifestation, hospitalization
     Control fever > antipyretics. Avoid aspirin.
     Monitor blood pressure

    PREVENTION
     Do not allow infected person to be bitten by
    mosquito. Use MOSQUITO BARRIERS/SCREEN
    DOORS
     Proper disposal of waste
     Clean surroundings
     Cover water containers
     Fumigation

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