Dengue is a viral infection caused by Flaviviridae group of viruses

1. A case presentation on Acute Febrile Illness
with Dengue ns1+ and Thrombocytopenia.

2. DEMOGRAPHIC DETAILS:
 NAME : XXX
 AGE : 16yrs
 SEX : male
 ADDRESS : Warangal
 IP NO : 4130
 DOCTOR : xxxx

3. REASONS FOR ADMISSION :
 Fever and joint pain since 2 days
 Vomiting 1 episode.

4. PAST MEDICAL HISTORY :
Nothing significant
FAMILY HISTORY : Nothing significant
SOCIAL HISTORY : Mixed diet,
Non alcoholic,
Non smoker.

5. VITAL SIGNS :
TEMP : 104F
BP : 100/70 mmHg
PR : 80 beats/min
RR : 22/min
O/E : Patient was conscious and coherent.
P°, Iº, Cº, Cº , Eº

6. PROVISIONAL DIAGNOSIS :
Acute Febrile illness.

7. DAY-1
TEMP : 104F BP : 110/70 mmHg
PR : 80 beats/min RR : 20/min
O/E : P°, Iº, Cº, Cº , Eº
C/O : Fever and joint pains.
ADV:CBP, Hemogram, LFT, Chest x ray.

8.  Medications
 Inj fepanil 100ml iv bid
 Inj monocef 1gm iv bid
 Inj pantoprazole 40mg iv bid
 Tab doxycycline 100mg po bid
 Tab dolo 650mg po tid
 Inj ondansetron 4mg iv tid
 Tab zincovit po once daily

9. LABORATORY DATA

10. PARAMETER NORMAL RANGE PATIENT
HEMOGLOBIN 12-18% 14.4
RBC 3.6-6.0m/cmm 4.8m/cmm
TOTAL WBC 4000-11000cells/cmm 9000cells/cmm
NEUTROPHILS 45-75% 60%
LYMPHOCYTES 20-45% 40%
EOSINOPHILS 1-6% 5%
PLATELET COUNT 1,50,000-4,50,000 100000

11.  FINAL DIAGNOSIS :
Acute febrile illness with Dengue ns1+ with
Thrombocytopenia.

12. SOAP NOTES

13.  Fever and joint pain since 2 days
 Vomiting 1 episode.

14. OBJECTIVE EVIDENCE
COMPLETE BLOOD PICTURE:
Platelet count is less than the Normal range ie, 100000
platelets and this is indicative of dengue.

15.  Dengue check :- Dengue ns1+ positive.

16. ASSESSMENT
Diagnosis : Based on the subjective and objective evidences
the diagnosis was found to be Acute febrile illness with
Dengue ns1+ with Thrombocytopenia.
Etiology:- viral infection spread through mosquito bite.
Assessment if therapy is indicated :
Yes therapy for this patient is absolutely essential to prevent
further complications like dengue haemorrhagic fever that can
cause an enlarged liver and in some cases can lead to shock.

17.  Standard therapy
 Treatment is concerned with relief of signs and
symptoms.
 pain relievers such as NSAIDS are necessary.
 Acetaminophen and codeine may be given for severe
headache and for joint and muscle pain (myalgia)
 Patients hospitalized for dengue may receive
continuous iv fluids.
 Carioca papaya leaf extract has been shown to be an
effective treatment for dengue fever.

18. Drug category Dose Frequency
Inj Paracetamol NSAID 1gm iv Bid
Inj Ceftriaxone 3rd gen
cephalosporins
1gm iv Bid
Inj Pantoprazole Proton pump
inhibitor
40 mg iv OD
Inj ondansetron 5HT3 antagonist 4mg iv Tid
Cap doxycycline Tetracycline
antibiotics
100mg po Bid

19. PLANNING
MONITORING PARAMETERS
THERAPEUTIC MONITORING:
Complete blood picture.
Dengue check :- monitoring the dengue to check the presence of
further IgM and IgG antibodies.

20. GOALS OF TREATMENT
GENERAL GOALS :
 To reduce morbidity and mortality,
 To improve quality of life,
 To prevent and treat complications
PATIENT SPECIFIC GOALS :
 To prevent the further complication of dengue
hemorrhagic fever, shock etc

21. LIFE STYLE MODIFICATIONS :
Wear a protective clothing.
Use mosquito repellant.
Dispose of garbage on regular basis.
Diet :- low fat, low fiber, and non carbonated.
Use fruits such as kiwi, pomegranate.
Use vegetables such as carrot and beet root.
Take adequate rest.

22. Thanking you All