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A Case Presentation on Dengue With Warning Signs
A 5-year old female child was admitted with 4 days of fever and chills, vomiting, abdominal pain, and fast breathing. Based on lab tests showing decreasing platelet and white blood cell counts and increasing hematocrit, she was diagnosed with dengue with warning signs. She was treated with intravenous fluids, antipyretics, antibiotics, antiemetics, and probiotics. Her symptoms improved and she was discharged after her vitals stabilized and lab values started recovering.
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A Case Presentation on Dengue With Warning Signs
- 1. Case presentation ondengue with warning signs Presented by : METI.BHARATH KUMAR 16DK1T0014 Pharm-D(Intern)
- 2. DEMOGRAPHIC DETAILS • NAME: XX • AGE : 5yrs • SEX : Female • DEPARTMENT : Pediatrics • Child Medical Ward II • ADMISSION DATE : 21 september, 2021. • ADMISSION NO: 50405 • Consultant physician : Dr Ravi krishna 5/12/2022 2
- 3. Subjective evaluation A 5year old female child admitted with chief complaints of • Fever with chills since 4 days not associated with rash • Vomiting 2 episodes • Abdominal pain • Fast breathing 5/12/2022 3
- 4. Objective evaluation The doctoradvise : CBP, Malarial Pasarite, Dengue, LFT CBP 23-10-21 24-10-21 25-10-21 26-10-21 27-10-21 28-10-21 Hemoglob in 12gm/dl 12.9gm/dl 15.5gm/dl 14.2gm/dl 12.5gm/dl 12.2gm/dl RBC 4.15million cells/mcL 4.78million cells/mcL 5.84million cells/mcL 5.28million cells/mcL 4.59million cells/mcL 4.36million cells/mcL WBC 5,800 cells/mcL 4,600cells/m cL 5,400cells/m cL 5,500 cells/mcL 6,400cells/m cL 7,700cells/m cL PLT 1,00,000 67,000 40,000 23,000 36,000 50,000 5/12/2022 4
- 5. ASSESSMENT Based on subjectiveand objective evaluation the patient is diagnosed as dengue with warning signs 5/12/2022 5
- 6. Monitor vitals VITALS 23-10-2124-10-21 25-10-21 26-10-21 27-10-21 28-10-21 29-10-21 Blood Pressure 110/70 mmHg 100/70 mmHg 90/70 mmHg 100/60 mmHg 100/60 mmHg 100/70 mmHg 100/60 mmHg P/A soft soft Loose stools distended distended soft soft SPO2 98% 98% 98% 97% 98% 96% 98% Pulse Rate 102bpm 110bpm 110bpm 111bpm 120bpm 100bpm 110bpm Respirator y Rate 22/min 20/min 28/min 26/min 27/min 25/min 20/min CRT < 3 sec < 3 sec < 3 sec < 3 sec < 3 sec 5/12/2022 6
- 7. Plan of treatment Tab Doxycycline 100mg BD 1-0- ½ (5 Days) Tab Paracetamol 500mg 1-1-1 (8 Days) Tab Pantop 40mg ½ -0-0 Tab Ondansetron ½ -0-0 Probiotics 1-0-1 IVF- RL, DNS Tab Cefixime 200mg 1-0-1 5/12/2022 7
- 8. DAYS 23-10-21 24-10-2125-10-21 26-10-21 27-10-21 28-10-21 29-10-21 SYMPTOMS Fever, vomiting Fever, myalgia, vomiting Fever spikes vomiting, loose stools 5-6 episodes Hepatomeg aly Vomiting, abdominal pain, fever Abdominal pain, vomiting Abdominal pain Abdominal pain ORS X X T PCT T PANTOP X X X X X T ONDANSETR ON X X X X X T DOXY X X INJ PANTOP X X X INJ VOMISET X X X IVF RL, DNS X X DNS : X DNS : X X X PROBIOTICS X X X X X 5/12/2022 8
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- 14. Probable dengue accordingto CDC • Patient lives or travelled to dengue endemic area .Patient also has fever and two or more of the following clinical features nausea,vomiting,rash,aches, tourniquet test positive,leukopenia,any warning signs warning signs: abdominal pain or tenderness persistent vomiting clinical fluid accumulation Mucosal bleed Lethargy or restlessness Liver enlargement 5/12/2022 14
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- 16. diagnosis COMPLETE BLOODPICTURE DENGUE KIT LIVER FUNCTION TEST ULTRASOUND ABDOMEN MALARIA KIT 5/12/2022 16
- 17. management There isno specific treatment for Dengue Oral rehydration therapy Intravenous fluids Plasma Rich Platelets Transfusion Symptom based Treatment 5/12/2022 17
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