As an intern house officer, I prepared this presentation after I came across a rare case of dengue fever complicated by hemophagocytic lymphohistiocytosis (HLH). Dengue fever itself is a rare disease entity in the UAE, as a developed country; and the presence of such a complication merely added to the complexity of the diagnosis. Therefore, I am delighted to share this lively PowerPoint Presentation about dengue, which was initially supplemented with an interesting case presentation but was removed for confidentiality purposes when sharing the document. I hope you enjoy it!
PS: Use the slideshow button in Microsoft PowerPoint for the best experience.
This document provides information about dengue, including its classification, signs and symptoms, diagnosis, treatment and prevention. Some key points:
- Dengue is a mosquito-borne viral disease caused by the dengue virus. There are four serotypes that can cause illness ranging from mild to severe.
- Symptoms of dengue fever include high fever, severe headache, muscle and joint pains. Warning signs of severe dengue include severe abdominal pain, vomiting, rapid breathing and bleeding.
- Dengue is classified as dengue fever, dengue hemorrhagic fever or dengue shock syndrome based on symptoms. Diagnosis involves detecting the virus or antibodies in blood tests.
- Prevention focuses on
Dengue fever is caused by any of the four dengue virus serotypes transmitted by Aedes mosquitoes. It causes flu-like symptoms including high fever, severe headache, muscle and joint pains. Dengue hemorrhagic fever is a severe complication characterized by bleeding, low platelets and fluid leakage. There are three phases: febrile, critical leakage and recovery. Prevention focuses on controlling the mosquito population.
This document provides an overview of dengue fever, including its etiology, epidemiology, clinical presentation, diagnosis, complications and management. Some key points include:
- Dengue fever is caused by the dengue virus and transmitted by Aedes mosquitoes. There are four serotypes.
- It is prevalent in tropical and subtropical regions and cases have been increasing worldwide due to factors like increased travel and urbanization.
- Clinical presentation depends on whether it is a primary or secondary infection. Secondary infections are more likely to develop into severe dengue hemorrhagic fever or dengue shock syndrome.
- Diagnosis involves serological tests to detect IgM and IgG antibodies or the NS1 antigen. C
Dengue, DHF, DSS, PREVENTION, MANAGEMENT, TREATMENTDr-Hem Shah
Dengue is a viral disease transmitted by mosquitoes. It causes flu-like symptoms including fever, headache, muscle and joint pains, and rash. In some cases it can develop into severe dengue hemorrhagic fever or dengue shock syndrome, resulting in bleeding, low blood pressure and organ failure. Diagnosis is usually clinical based on symptoms and signs. Treatment focuses on fluid replacement and symptom relief. Prevention involves controlling mosquito breeding sites and using protective measures against mosquito bites. Homeopathy offers several remedies that can help manage symptoms and aid recovery from dengue fever.
Dengue, DHF, DSS, prevention, prognosis and its managementDr. Hem Shah
Dengue is a viral disease transmitted by mosquitoes. It causes flu-like symptoms including fever, headache, muscle and joint pains, and rash. In some cases it can develop into severe dengue hemorrhagic fever or dengue shock syndrome, resulting in bleeding, low blood pressure and organ failure. Diagnosis is usually clinical based on symptoms and signs. Treatment focuses on fluid replacement and symptom relief. Prevention involves controlling mosquito breeding sites and using protective measures against mosquito bites. Homeopathy offers several remedies that can help manage symptoms and aid recovery from dengue fever.
The document discusses dengue virus, its transmission and clinical manifestations. Some key points:
- Dengue virus is transmitted by Aedes aegypti mosquitoes and has 4 serotypes. It causes dengue fever and the more severe dengue hemorrhagic fever/dengue shock syndrome.
- The disease progresses through febrile, critical, and recovery phases. During the critical phase, plasma leakage and bleeding can cause shock.
- Symptoms range from mild fever to severe bleeding, organ impairment and shock. Thrombocytopenia is common.
- Diagnosis is based on clinical criteria and confirmed with serology, antigen or PCR testing. There is no vaccine and treatment focuses
This document provides information about dengue, including its classification, signs and symptoms, diagnosis, treatment and prevention. Some key points:
- Dengue is a mosquito-borne viral disease caused by the dengue virus. There are four serotypes that can cause illness ranging from mild to severe.
- Symptoms of dengue fever include high fever, severe headache, muscle and joint pains. Warning signs of severe dengue include severe abdominal pain, vomiting, rapid breathing and bleeding.
- Dengue is classified as dengue fever, dengue hemorrhagic fever or dengue shock syndrome based on symptoms. Diagnosis involves detecting the virus or antibodies in blood tests.
- Prevention focuses on
Dengue fever is caused by any of the four dengue virus serotypes transmitted by Aedes mosquitoes. It causes flu-like symptoms including high fever, severe headache, muscle and joint pains. Dengue hemorrhagic fever is a severe complication characterized by bleeding, low platelets and fluid leakage. There are three phases: febrile, critical leakage and recovery. Prevention focuses on controlling the mosquito population.
This document provides an overview of dengue fever, including its etiology, epidemiology, clinical presentation, diagnosis, complications and management. Some key points include:
- Dengue fever is caused by the dengue virus and transmitted by Aedes mosquitoes. There are four serotypes.
- It is prevalent in tropical and subtropical regions and cases have been increasing worldwide due to factors like increased travel and urbanization.
- Clinical presentation depends on whether it is a primary or secondary infection. Secondary infections are more likely to develop into severe dengue hemorrhagic fever or dengue shock syndrome.
- Diagnosis involves serological tests to detect IgM and IgG antibodies or the NS1 antigen. C
Dengue, DHF, DSS, PREVENTION, MANAGEMENT, TREATMENTDr-Hem Shah
Dengue is a viral disease transmitted by mosquitoes. It causes flu-like symptoms including fever, headache, muscle and joint pains, and rash. In some cases it can develop into severe dengue hemorrhagic fever or dengue shock syndrome, resulting in bleeding, low blood pressure and organ failure. Diagnosis is usually clinical based on symptoms and signs. Treatment focuses on fluid replacement and symptom relief. Prevention involves controlling mosquito breeding sites and using protective measures against mosquito bites. Homeopathy offers several remedies that can help manage symptoms and aid recovery from dengue fever.
Dengue, DHF, DSS, prevention, prognosis and its managementDr. Hem Shah
Dengue is a viral disease transmitted by mosquitoes. It causes flu-like symptoms including fever, headache, muscle and joint pains, and rash. In some cases it can develop into severe dengue hemorrhagic fever or dengue shock syndrome, resulting in bleeding, low blood pressure and organ failure. Diagnosis is usually clinical based on symptoms and signs. Treatment focuses on fluid replacement and symptom relief. Prevention involves controlling mosquito breeding sites and using protective measures against mosquito bites. Homeopathy offers several remedies that can help manage symptoms and aid recovery from dengue fever.
The document discusses dengue virus, its transmission and clinical manifestations. Some key points:
- Dengue virus is transmitted by Aedes aegypti mosquitoes and has 4 serotypes. It causes dengue fever and the more severe dengue hemorrhagic fever/dengue shock syndrome.
- The disease progresses through febrile, critical, and recovery phases. During the critical phase, plasma leakage and bleeding can cause shock.
- Symptoms range from mild fever to severe bleeding, organ impairment and shock. Thrombocytopenia is common.
- Diagnosis is based on clinical criteria and confirmed with serology, antigen or PCR testing. There is no vaccine and treatment focuses
Dengue is an arbovirus that infects humans and causes disease ranging from a self-limiting dengue fever to the potentially fatal dengue hemorrhagic fever. It is transmitted by Aedes mosquitoes and is endemic in over 100 tropical and subtropical countries. There are four dengue virus serotypes. Infection with one serotype provides lifelong immunity to that serotype but only short-term protection against the others. A secondary infection with a different serotype increases the risk of severe dengue. Dengue fever causes high fever, headache, muscle and joint pains. Dengue hemorrhagic fever involves plasma leakage that can lead to life-threatening shock. There are three phases: febrile
Dengue is a mosquito-borne viral disease that infects 50-100 million people annually. It is caused by the dengue virus, of which there are 4 serotypes. Infection with one serotype provides lifelong immunity to that serotype but only temporary protection against the others. Secondary infections pose greater risk of severe disease. Dengue ranges from a self-limiting fever to life-threatening dengue hemorrhagic fever/dengue shock syndrome. Diagnosis involves identifying symptoms, performing serological tests, and detecting virus or antibodies. There is no vaccine or specific treatment, so care focuses on fluid replacement and symptom relief.
Dengue is a viral disease spread by Aedes mosquitoes. It causes flu-like symptoms and in severe cases, hemorrhagic fever or shock syndrome. There are 4 serotypes of the dengue virus. Secondary infection with a different serotype increases the risk of severe disease due to antibody-dependent enhancement. Diagnosis involves identifying antibodies, virus or viral components. Treatment focuses on fluid replacement and supportive care. Prevention emphasizes controlling mosquito populations and developing effective vaccines.
Dengue is a viral disease spread by Aedes mosquitoes. It causes fever, joint pains, and rash. There are 4 serotypes that provide immunity only to that serotype. Secondary infection by a different serotype increases risk of severe dengue which can cause bleeding, low platelets and shock. It is endemic in over 100 tropical and subtropical countries. Prevention focuses on controlling mosquito populations and developing effective vaccines.
Dengue fever is an infectious tropical disease caused by the dengue virus and transmitted by several species of mosquito, principally Aedes aegypti. The virus causes a fever and severe joint and muscle pains. In some cases it develops into life-threatening dengue hemorrhagic fever or dengue shock syndrome, resulting in bleeding, low blood pressure and organ dysfunction. There is no vaccine, so prevention depends on controlling mosquito habitats and bites. Nurses monitor hydration and blood products in severe cases and educate people on preventing mosquito breeding.
- Dengue fever is a viral illness transmitted by mosquitoes that has increased dramatically globally in recent decades. It is caused by one of four dengue virus serotypes.
- The Aedes aegypti mosquito is the primary vector for transmitting the dengue viruses. It breeds in standing water and bites humans to acquire the virus.
- The illness begins with a high fever and other flu-like symptoms lasting 2-7 days. Some patients may develop a more severe form with bleeding and shock called dengue hemorrhagic fever. Treatment focuses on relieving symptoms and careful monitoring during recovery.
Dengue fever, also known as breakbone fever, is caused by the dengue virus and transmitted by Aedes mosquitoes. It is endemic in over 110 countries, infecting 50-100 million people annually. Symptoms include high fever, headache, muscle and joint pains, and a rash. In a small percentage of cases, it can develop into severe dengue hemorrhagic fever or dengue shock syndrome, which can be life-threatening. There is no vaccine, so prevention depends on controlling mosquito populations and avoiding bites. Nurses play an important role in monitoring patients, providing rehydration and blood transfusions if needed, and educating on prevention.
1. The document provides guidelines for diagnosing and treating dengue fever, which is caused by the dengue virus and transmitted by Aedes aegypti mosquitoes.
2. It outlines the typical phases of dengue illness - febrile, critical, and recovery phase - and describes the clinical manifestations at each stage.
3. Patients are classified into groups - A, B, or C - depending on severity of symptoms and need for home care versus hospital admission and management. Close monitoring is important to watch for warning signs and progression to more severe disease.
Dr Deepak Dadhich DENGUE FEVER ppt under guidance of Dr Jitendra Verma Sir Pr...HakunaMatata198441
Dengue is caused by four serotypes of dengue virus transmitted by Aedes mosquitoes. The document discusses the pathophysiology, classification, clinical presentation, investigations and management of dengue. It describes the three phases of illness - febrile, critical and recovery phase. Treatment involves symptomatic relief and careful fluid management to prevent complications of plasma leakage and shock. Hospital admission is required if warning signs or severe symptoms are present.
Dengue fever is a mosquito-borne viral disease transmitted by Aedes aegypti and Aedes albopictus mosquitoes. It is caused by the dengue virus, of which there are four serotypes. The disease places a large burden globally, with most cases occurring in Asia. Clinical manifestations range from a self-limiting flu-like illness to severe dengue, which can be fatal if not properly treated. Diagnosis involves virus detection, antigen testing, or serology. There is no vaccine or specific antiviral treatment, so management focuses on fluid replacement and symptom relief. Complications include bleeding, organ impairment, and fluid imbalance.
A mosquito-borne viral disease occurring in tropical and subtropical areas.
Those who become infected with the virus a second time are at a significantly greater risk of developing severe disease.
Symptoms include high fever, headache, rash and muscle and joint pain. In severe cases there is serious bleeding and shock, which can be life threatening.
Treatment includes fluids and pain relievers. Severe cases require hospital care.
Dengue&dhf information for health care practitioners 2009Tonzaaton Oozaa
Dengue is a mosquito-borne viral disease with four serotypes. It is transmitted by Aedes mosquitoes, most commonly Aedes aegypti. While dengue fever causes high fever and joint pain, some patients develop dengue hemorrhagic fever or dengue shock syndrome, which can be fatal without treatment. Diagnosis involves virus isolation, PCR, or serologic testing for IgM antibodies. Treatment focuses on fluid replacement and monitoring for warning signs of severe disease.
This document discusses liver involvement in exotic viral infections, focusing on Dengue fever and Yellow fever. The key points are:
1. The liver is often affected in exotic viral infections, either as the primary target organ or being only marginally affected. Dengue and Yellow fever commonly cause liver involvement.
2. Dengue fever commonly causes mild to moderate elevations in liver enzymes, especially AST, though severe hepatitis can occur in dengue hemorrhagic fever. The liver involvement in Dengue generally resolves within 3 weeks.
3. Yellow fever virus primarily targets the liver, causing hepatocyte apoptosis and Councilman bodies. Liver enzyme elevations are proportional to disease severity and elevated AST is more common than
Dengue fever is a mosquito-borne viral infection that causes flu-like symptoms including fever, headache, muscle and joint pains. It is transmitted by Aedes mosquitoes, primarily Aedes aegypti. There are four types of dengue virus. Secondary infection with a different virus type increases the risk of developing severe dengue, which can be life-threatening. Common symptoms include fever, rash and bleeding. There is no vaccine available, so prevention focuses on controlling mosquito breeding and getting prompt medical care for warning signs of severe dengue.
Dengue is a mosquito-borne viral disease that has been an increasing problem in India. It is transmitted by the Aedes aegypti mosquito. There are typically two peaks of dengue outbreaks annually in India. The number of reported cases and deaths has been increasing, with over 99,000 cases and 220 deaths in 2015. The goal of the Global Strategy for Dengue Prevention and Control is to reduce dengue mortality by at least 50% and morbidity by 25% by 2020 through reducing mosquito populations, public education, and emergency response planning. Diagnosis involves virus isolation, antibody detection, or PCR testing. There is no vaccine for dengue prevention currently.
The document discusses dengue, which is endemic in many countries in Southeast Asia and the Western Pacific. It categorizes countries in Southeast Asia based on their dengue situation. India is experiencing an increase in dengue risk due to factors like rapid urbanization and lifestyle changes. The dengue virus has four serotypes and infection with one provides immunity to that serotype. Secondary infection or infection with multiple serotypes can cause severe dengue hemorrhagic fever. The Aedes mosquito transmits dengue virus between humans. Environmental factors like rainfall and temperature affect mosquito populations and transmission rates.
Dengue is a mosquito-borne viral infection found worldwide in tropical and subtropical regions. It is transmitted by the Aedes aegypti mosquito. The document discusses the definition, epidemiology, virus, transmission cycle, clinical stages and symptoms, investigations, diagnosis, treatment, prevention and control of dengue fever. Key points include that dengue is caused by four distinct virus serotypes, causes flu-like symptoms and in severe cases can lead to dengue hemorrhagic fever or dengue shock syndrome, and prevention focuses on eliminating mosquito breeding sites and seeking early medical care if infected.
Dengue virus is transmitted through the bites of infected Aedes mosquitoes. It can cause a range of illnesses from mild dengue fever to severe dengue hemorrhagic fever and dengue shock syndrome. Symptoms range from fever, rash and joint pain to bleeding, low blood pressure and death. Diagnosis involves virus detection, antibody testing or assessment of clinical symptoms and exposure history. There is no vaccine for dengue prevention and treatment focuses on rest, fluids and medication for fever or pain.
DENGUE FEVER BY DR.RADHE.pptx CIVIL HOSPITAL NEPALRAMJIBANYADAV2
Dengue fever is a mosquito-borne viral illness that has spread rapidly worldwide. It is transmitted by Aedes mosquitoes and causes flu-like symptoms including fever, headache, muscle pain and rash. There are four distinct serotypes of the dengue virus. Most cases resolve without complications, but severe dengue can occur, characterized by plasma leakage, bleeding or organ impairment. Treatment depends on severity of symptoms and involves oral rehydration or intravenous fluids and blood transfusions in severe cases.
DENGUE FEVER BY DR.RADHE.pptx CIVIL HOSPITAL NEPALRAMJIBANYADAV2
Dengue fever is a mosquito-borne viral illness that has spread rapidly worldwide. It is transmitted by Aedes mosquitoes and causes flu-like symptoms including fever, headache, muscle pain and rash. There are four distinct serotypes of the dengue virus. Most cases resolve without complications, but severe dengue can occur, characterized by plasma leakage, bleeding or organ impairment. Treatment depends on severity of symptoms and involves oral rehydration or intravenous fluids and blood transfusions in severe cases.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Dengue is an arbovirus that infects humans and causes disease ranging from a self-limiting dengue fever to the potentially fatal dengue hemorrhagic fever. It is transmitted by Aedes mosquitoes and is endemic in over 100 tropical and subtropical countries. There are four dengue virus serotypes. Infection with one serotype provides lifelong immunity to that serotype but only short-term protection against the others. A secondary infection with a different serotype increases the risk of severe dengue. Dengue fever causes high fever, headache, muscle and joint pains. Dengue hemorrhagic fever involves plasma leakage that can lead to life-threatening shock. There are three phases: febrile
Dengue is a mosquito-borne viral disease that infects 50-100 million people annually. It is caused by the dengue virus, of which there are 4 serotypes. Infection with one serotype provides lifelong immunity to that serotype but only temporary protection against the others. Secondary infections pose greater risk of severe disease. Dengue ranges from a self-limiting fever to life-threatening dengue hemorrhagic fever/dengue shock syndrome. Diagnosis involves identifying symptoms, performing serological tests, and detecting virus or antibodies. There is no vaccine or specific treatment, so care focuses on fluid replacement and symptom relief.
Dengue is a viral disease spread by Aedes mosquitoes. It causes flu-like symptoms and in severe cases, hemorrhagic fever or shock syndrome. There are 4 serotypes of the dengue virus. Secondary infection with a different serotype increases the risk of severe disease due to antibody-dependent enhancement. Diagnosis involves identifying antibodies, virus or viral components. Treatment focuses on fluid replacement and supportive care. Prevention emphasizes controlling mosquito populations and developing effective vaccines.
Dengue is a viral disease spread by Aedes mosquitoes. It causes fever, joint pains, and rash. There are 4 serotypes that provide immunity only to that serotype. Secondary infection by a different serotype increases risk of severe dengue which can cause bleeding, low platelets and shock. It is endemic in over 100 tropical and subtropical countries. Prevention focuses on controlling mosquito populations and developing effective vaccines.
Dengue fever is an infectious tropical disease caused by the dengue virus and transmitted by several species of mosquito, principally Aedes aegypti. The virus causes a fever and severe joint and muscle pains. In some cases it develops into life-threatening dengue hemorrhagic fever or dengue shock syndrome, resulting in bleeding, low blood pressure and organ dysfunction. There is no vaccine, so prevention depends on controlling mosquito habitats and bites. Nurses monitor hydration and blood products in severe cases and educate people on preventing mosquito breeding.
- Dengue fever is a viral illness transmitted by mosquitoes that has increased dramatically globally in recent decades. It is caused by one of four dengue virus serotypes.
- The Aedes aegypti mosquito is the primary vector for transmitting the dengue viruses. It breeds in standing water and bites humans to acquire the virus.
- The illness begins with a high fever and other flu-like symptoms lasting 2-7 days. Some patients may develop a more severe form with bleeding and shock called dengue hemorrhagic fever. Treatment focuses on relieving symptoms and careful monitoring during recovery.
Dengue fever, also known as breakbone fever, is caused by the dengue virus and transmitted by Aedes mosquitoes. It is endemic in over 110 countries, infecting 50-100 million people annually. Symptoms include high fever, headache, muscle and joint pains, and a rash. In a small percentage of cases, it can develop into severe dengue hemorrhagic fever or dengue shock syndrome, which can be life-threatening. There is no vaccine, so prevention depends on controlling mosquito populations and avoiding bites. Nurses play an important role in monitoring patients, providing rehydration and blood transfusions if needed, and educating on prevention.
1. The document provides guidelines for diagnosing and treating dengue fever, which is caused by the dengue virus and transmitted by Aedes aegypti mosquitoes.
2. It outlines the typical phases of dengue illness - febrile, critical, and recovery phase - and describes the clinical manifestations at each stage.
3. Patients are classified into groups - A, B, or C - depending on severity of symptoms and need for home care versus hospital admission and management. Close monitoring is important to watch for warning signs and progression to more severe disease.
Dr Deepak Dadhich DENGUE FEVER ppt under guidance of Dr Jitendra Verma Sir Pr...HakunaMatata198441
Dengue is caused by four serotypes of dengue virus transmitted by Aedes mosquitoes. The document discusses the pathophysiology, classification, clinical presentation, investigations and management of dengue. It describes the three phases of illness - febrile, critical and recovery phase. Treatment involves symptomatic relief and careful fluid management to prevent complications of plasma leakage and shock. Hospital admission is required if warning signs or severe symptoms are present.
Dengue fever is a mosquito-borne viral disease transmitted by Aedes aegypti and Aedes albopictus mosquitoes. It is caused by the dengue virus, of which there are four serotypes. The disease places a large burden globally, with most cases occurring in Asia. Clinical manifestations range from a self-limiting flu-like illness to severe dengue, which can be fatal if not properly treated. Diagnosis involves virus detection, antigen testing, or serology. There is no vaccine or specific antiviral treatment, so management focuses on fluid replacement and symptom relief. Complications include bleeding, organ impairment, and fluid imbalance.
A mosquito-borne viral disease occurring in tropical and subtropical areas.
Those who become infected with the virus a second time are at a significantly greater risk of developing severe disease.
Symptoms include high fever, headache, rash and muscle and joint pain. In severe cases there is serious bleeding and shock, which can be life threatening.
Treatment includes fluids and pain relievers. Severe cases require hospital care.
Dengue&dhf information for health care practitioners 2009Tonzaaton Oozaa
Dengue is a mosquito-borne viral disease with four serotypes. It is transmitted by Aedes mosquitoes, most commonly Aedes aegypti. While dengue fever causes high fever and joint pain, some patients develop dengue hemorrhagic fever or dengue shock syndrome, which can be fatal without treatment. Diagnosis involves virus isolation, PCR, or serologic testing for IgM antibodies. Treatment focuses on fluid replacement and monitoring for warning signs of severe disease.
This document discusses liver involvement in exotic viral infections, focusing on Dengue fever and Yellow fever. The key points are:
1. The liver is often affected in exotic viral infections, either as the primary target organ or being only marginally affected. Dengue and Yellow fever commonly cause liver involvement.
2. Dengue fever commonly causes mild to moderate elevations in liver enzymes, especially AST, though severe hepatitis can occur in dengue hemorrhagic fever. The liver involvement in Dengue generally resolves within 3 weeks.
3. Yellow fever virus primarily targets the liver, causing hepatocyte apoptosis and Councilman bodies. Liver enzyme elevations are proportional to disease severity and elevated AST is more common than
Dengue fever is a mosquito-borne viral infection that causes flu-like symptoms including fever, headache, muscle and joint pains. It is transmitted by Aedes mosquitoes, primarily Aedes aegypti. There are four types of dengue virus. Secondary infection with a different virus type increases the risk of developing severe dengue, which can be life-threatening. Common symptoms include fever, rash and bleeding. There is no vaccine available, so prevention focuses on controlling mosquito breeding and getting prompt medical care for warning signs of severe dengue.
Dengue is a mosquito-borne viral disease that has been an increasing problem in India. It is transmitted by the Aedes aegypti mosquito. There are typically two peaks of dengue outbreaks annually in India. The number of reported cases and deaths has been increasing, with over 99,000 cases and 220 deaths in 2015. The goal of the Global Strategy for Dengue Prevention and Control is to reduce dengue mortality by at least 50% and morbidity by 25% by 2020 through reducing mosquito populations, public education, and emergency response planning. Diagnosis involves virus isolation, antibody detection, or PCR testing. There is no vaccine for dengue prevention currently.
The document discusses dengue, which is endemic in many countries in Southeast Asia and the Western Pacific. It categorizes countries in Southeast Asia based on their dengue situation. India is experiencing an increase in dengue risk due to factors like rapid urbanization and lifestyle changes. The dengue virus has four serotypes and infection with one provides immunity to that serotype. Secondary infection or infection with multiple serotypes can cause severe dengue hemorrhagic fever. The Aedes mosquito transmits dengue virus between humans. Environmental factors like rainfall and temperature affect mosquito populations and transmission rates.
Dengue is a mosquito-borne viral infection found worldwide in tropical and subtropical regions. It is transmitted by the Aedes aegypti mosquito. The document discusses the definition, epidemiology, virus, transmission cycle, clinical stages and symptoms, investigations, diagnosis, treatment, prevention and control of dengue fever. Key points include that dengue is caused by four distinct virus serotypes, causes flu-like symptoms and in severe cases can lead to dengue hemorrhagic fever or dengue shock syndrome, and prevention focuses on eliminating mosquito breeding sites and seeking early medical care if infected.
Dengue virus is transmitted through the bites of infected Aedes mosquitoes. It can cause a range of illnesses from mild dengue fever to severe dengue hemorrhagic fever and dengue shock syndrome. Symptoms range from fever, rash and joint pain to bleeding, low blood pressure and death. Diagnosis involves virus detection, antibody testing or assessment of clinical symptoms and exposure history. There is no vaccine for dengue prevention and treatment focuses on rest, fluids and medication for fever or pain.
DENGUE FEVER BY DR.RADHE.pptx CIVIL HOSPITAL NEPALRAMJIBANYADAV2
Dengue fever is a mosquito-borne viral illness that has spread rapidly worldwide. It is transmitted by Aedes mosquitoes and causes flu-like symptoms including fever, headache, muscle pain and rash. There are four distinct serotypes of the dengue virus. Most cases resolve without complications, but severe dengue can occur, characterized by plasma leakage, bleeding or organ impairment. Treatment depends on severity of symptoms and involves oral rehydration or intravenous fluids and blood transfusions in severe cases.
DENGUE FEVER BY DR.RADHE.pptx CIVIL HOSPITAL NEPALRAMJIBANYADAV2
Dengue fever is a mosquito-borne viral illness that has spread rapidly worldwide. It is transmitted by Aedes mosquitoes and causes flu-like symptoms including fever, headache, muscle pain and rash. There are four distinct serotypes of the dengue virus. Most cases resolve without complications, but severe dengue can occur, characterized by plasma leakage, bleeding or organ impairment. Treatment depends on severity of symptoms and involves oral rehydration or intravenous fluids and blood transfusions in severe cases.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
4. Introduction to
Dengue
• Dengue viruses are arboviruses from the
Flaviviridae family capable of infecting
humans and causing disease.
• The spectrum of clinical presentation ranges
from no symptoms to hemorrhages with
severe shock.
• The majority of cases of dengue infection
present as dengue fever, which is a self-
limiting disease.
A Case Presentation and Recap of Dengue 4
5. Epidemiology
• Dengue is found in tropical and subtropical regions around
the world, predominantly in urban and semi-urban areas.
• About 3.9 billion people in 128 countries are at risk of
infection with dengue viruses.
• A recent estimate indicates 390 million dengue infections
per year, of which 96 manifest clinically with any severity of
the disease.
• The number of reported cases in 2015 was 3.2 million.
• Worldwide, annually about 500,000 people with DHF
require hospitalization. Approximately 90 percent of them
are children aged less than five years, and about 2.5
percent of those affected die.
A Case Presentation and Recap of Dengue 5
7. A Case Presentation and Recap of Dengue 7
Dengue
Virus
DENV1
DENV2
DENV3
DENV4
8. Dengue Virus
• Infection with any one serotype confers
lifelong immunity to that virus serotype.
• They elicit cross-protection for only a few
months after infection by anyone of them.
• Secondary infection with dengue serotype
2 or multiple infections with different
serotypes lead to severe form dengue
DHF/DSS.
A Case Presentation and Recap of Dengue 8
9. Antibody-Dependent Enhancement
A Case Presentation and Recap of Dengue 9
Increase in the replication of the virus and a higher risk of severe dengue (immunological
catastrophe)
The antibodies help the virus infect monocytes more efficiently
The Ab–virus complex attaches to receptors called Fcγ receptors (FcγR) on circulating monocytes
The antibodies from the primary infection do not neutralize the virus
Subsequent infection with a different dengue virus serotype
Primary infection with dengue virus (sensitization)
12. Vector
• The two most important vectors are Aedes
aegypti and Aedes Albopictus
• Both carry high vectorial competency for
dengue virus: high susceptibility to
infecting virus, ability to replicate the virus,
and ability to transmit the virus to another
host
A Case Presentation and Recap of Dengue 12
13. Environmental Factors
• The population of Ae. aegypti fluctuates
with rainfall and water storage.
• Its life span is influenced by temperature
and humidity, and survives best between
16°C- 30°C and relative humidity of 60-80
percent.
• It breeds in the containers in and around
the houses.
A Case Presentation and Recap of Dengue 13
14. Community
A number of factors contribute to the initiation
and
maintenance of an epidemic of dengue
• The strain of the virus, which may influence
the magnitude and duration of the viremia in
humans
• The density, behaviour, and vectorial capacity
of the vector population
• The susceptibility of the human population
(both genetic factors and pre-existing immune
profile)
• The introduction of the virus into a receptive
A Case Presentation and Recap of Dengue 14
15. A Case Presentation and Recap of Dengue 15
Dengue virus
infection
Asymptomatic
(majority of cases)
Symptomatic
Undifferentiated
fever (viral
syndrome)
Dengue fever
With hemorrhage
Without
hemorrhage
Expanded dengue
syndrome/isolated
organopathy
(unusual
manifestation)
Dengue
hemorrhagic fever
(DHF) (with plasma
leakage)
DHF non-shock
DHF with dengue
shock syndrome
(DSS)
16. A Case Presentation and Recap of Dengue 16
Dengue virus
infection
Asymptomatic
(majority of cases)
Symptomatic
Undifferentiated
fever (viral
syndrome)
Dengue fever
With hemorrhage
Without
hemorrhage
Expanded dengue
syndrome/isolated
organopathy
(unusual
manifestation)
Dengue
hemorrhagic fever
(DHF) (with plasma
leakage)
DHF non-shock
DHF with dengue
shock syndrome
(DSS)
17. Undifferentiated
Fever
• Infants, children, and adults who have been infected
with the dengue virus, especially for the first time, may
develop a simple fever indistinguishable from other viral
infections.
• Maculopapular rashes may accompany the fever or
may appear during defervescence.
• Upper respiratory and gastrointestinal symptoms are
common.
A Case Presentation and Recap of Dengue 17
18. Dengue Fever
• All ages and both sexes are susceptible to dengue
fever.
• Children usually have a milder disease than adults.
• The illness is characterized by an incubation period of 3
to 10 days (commonly 5-6 days).
• The onset is sudden, with chills and high fever, intense
headache, and muscle and joint pains, which prevent all
movement.
• Within 24 hours retroorbital pain, particularly on eye
movements or eye pressure and photophobia develops.
• Other common symptoms include extreme weakness,
anorexia, constipation, altered taste sensation, colicky
pain, abdominal tenderness, dragging pain in the
inguinal region, sore throat, and general depression.
A Case Presentation and Recap of Dengue 18
19. Dengue Fever CONT
• Fever is usually between 39 °C and 40 °C, and it is
typically followed by a remission of a few hours to 2
days (biphasic curve).
• Fever lasts for about 5 days, rarely more than 7 days,
after which recovery is usually complete although
convalescence may be protracted.
• The case fatality is exceedingly low.
A Case Presentation and Recap of Dengue 19
20. Dengue Fever CONT
• The skin eruptions appear in 80 percent of cases during the
remission or during the second febrile phase, which lasts for
1- 2 days.
• The rash may be diffuse flushing, mottling, or fleeting pin-point
eruptions on the face, neck, and chest during the first half of
the febrile period.
• In addition, a conspicuous rash, that may be maculopapular
or scarlatiniform on the 3rd or 4th day may appear.
• It starts on the chest and trunk and may spread to the
extremities and rarely to the face. It may be accompanied by
itching and hyperaesthesia.
• The rash lasts for 2 hours to several days and may be
followed by desquamation.
A Case Presentation and Recap of Dengue 20
21. A Case Presentation and Recap of Dengue 21
Criteria for DF Probable diagnosis
• Acute febrile illness with two or more of the
following;
• Headache,
• Retro-orbital pain,
• Myalgia,
• Arthralgia/bone pain,
• Rash,
• Hemorrhagic manifestations,
• Leukopenia(WBC ≤ 5000 cells/mm3),
• Thrombocytopenia (platelet count < 150,000
cells/mm3),
• Rising hematocrit (5-10%);
• And one of the following:
• Supportive serology on single serum sample:
titer ≥ 1280 with haemagglutination inhibition
test, comparable IgG titer with enzyme-linked
immunosorbent assay, or testing positive in IgM
antibody test, and
• An occurrence at the same location and time as
confirmed cases of dengue fever.
Criteria for DF Confirmed diagnosis
• Probable case with at least one of the following :
• Isolation of dengue virus from serum, CSF, or
autopsy samples
• Fourfold or greater increase in serum lgG (by
hemagglutination inhibition test) or increase in lgM
antibody specific to dengue virus.
• Detection of dengue virus or antigen in tissue,
serum, or cerebrospinal fluid by
immunohistochemistry, immunofluorescence. or
enzyme-linked immunosorbent assay.
• Detection of dengue virus genomic sequences by
reverse transcription-polymerase chain reaction.
22. A Case Presentation and Recap of Dengue 22
Dengue virus
infection
Symptomatic
Undifferentiated
fever (viral
syndrome)
Dengue fever
With hemorrhage
Without
hemorrhage
Expanded dengue
syndrome/isolated
organopathy
(unusual
manifestation)
Dengue
hemorrhagic fever
(DHF) (with plasma
leakage)
DHF non-shock
DHF with dengue
shock syndrome
(DSS)
Asymptomatic
(majority of cases)
23. Dengue Hemorrhagic Fever (DHF)
A Case Presentation and Recap of Dengue 23
Febrile
phase
Critical
phase
Recovery
phase
24. DHF Febrile Phase
• Following an incubation period of four to six days, the
illness commonly begins abruptly with a high fever (up
to 40°C to 41°C) accompanied by facial flushing and
headache.
• Commonly associated symptoms include Anorexia,
vomiting, epigastric discomfort, tenderness at the right
costal margin, and generalized abdominal pain.
• During the first few days the illness usually resembles
classical DF.
• A maculopapular rash, usually rubelliform type, is less
common.
A Case Presentation and Recap of Dengue 24
25. DHF Febrile Phase
• Plasma leakage and abnormal haemostasis,
manifested by a rising haematocrit value and
moderate to marked thrombocytopenia, are
unique and constant features of DHF.
• These two clinical laboratory changes
determine the severity of the disease in DHF
and differentiate it from DF.
• A positive tourniquet test is the most common
haemorrhagic phenomenon.
A Case Presentation and Recap of Dengue 25
26. Torniquet Test
• The test is performed by:
• inflating a blood pressure cuff to a midpoint
between systolic and diastolic pressure for 5
minutes
• The test is considered positive when 10 or more
petechiae per 2.5 x 2.5cm (1-inch square) are
observed.
• In DHF, the test is usually a definite positive with 20
petechiae or more.
A Case Presentation and Recap of Dengue 26
27. Dengue Hemorrhagic Fever (DHF)
A Case Presentation and Recap of Dengue 27
Febrile
phase
Critical
phase
Recovery
phase
28. DHF Critical Phase
• Around the time of defervescence, usually in
days 3-7 of illness, an increase in capillary
permeability and hematocrit may occur.
• This marks the beginning of a period of
significant plasma leakage that usually lasts
24-48 hours (critical phase).
• Leukopenia and thrombocytopenia usually
precede plasma leakage.
• Pleural effusion and ascites may be clinically
detectable.
A Case Presentation and Recap of Dengue 28
29. DHF Dengue Shock Syndrome
• Shock happens when a critical volume of
plasma is lost through leakage.
• With prolonged shock, organ hypoperfusion
occurs resulting in organ dysfunction,
metabolic acidosis, and DIC.
• The resultant severe hemorrhage causes the
hematocrit to decrease in this phase. The
WBC may also increase.
A Case Presentation and Recap of Dengue 29
30. Dengue Hemorrhagic Fever (DHF)
A Case Presentation and Recap of Dengue 30
Febrile
phase
Critical
phase
Recovery
phase
31. Recovery Phase
• A gradual reabsorption of fluid from the
extravascular compartment occurs in the 48-
72 hours after defervescence if the patient
survives the critical phase.
• The symptoms and general well-being
improve.
• Bradycardia and ECG changes are common
and generalized pruritis may develop.
• The hematocrit stabilizes and WBC starts to
rise before platelets.
• Excessive fluid therapy may precipitate CHF
or pleural effusions.
A Case Presentation and Recap of Dengue 31
32. A Case Presentation and Recap of Dengue 32
• All of the following:
• Acute onset of fever of two to seven days duration
• Hemorrhagic manifestations, shown by any of the
following: positive tourniquet test, petechiae, ecchymoses,
purpura, or bleeding from the mucosa, gastrointestinal
tract, injection sites, or other locations
• Platelet count ≤ 100,000 cells/mm3
• Objective evidence of plasma leakage due to increased
vascular permeability shown by any of the following:
• Rising hematocrit/hemoconcentration ≥ 20% from
baseline
• Evidence of plasma leakage such as pleural effusion,
ascites or hypoproteinemia/albuminemia
DHF Criteria
33. A Case Presentation and Recap of Dengue 33
• Criteria for DHF as above with signs of shock
including :
• Tachycardia, cool extremities, delayed capillary
refill, weak pulse, lethargy, or restlessness, which
may be a sign of reduced brain perfusion
• Pulse pressure ≤ 20 mmHg with increased
diastolic pressure, e.g. 100/80 mmHg
• Hypotension by age, defined as systolic pressure
<80 mmHg for those aged <5 years, or 80 to 90
mmHg for older children and adults
DSS Criteria
34. Laboratory Diagnosis
A Case Presentation and Recap of Dengue 34
Detection of the
virus/viral
components
Serological
response
• Viral isolation: mosquito/mosquito cell
culture inoculation
• Nucleic acid detection (RT-PCR and real
time RT-PCR)
• Antigen detection (NS1 Ag rapid tests and
ELISA)
• Paired sera (acute serum days 1-5 and
second serum days 15-21): IgM or IgG
seroconversion by ELISA,
hemagglutination assay, or neutralization
• Serum after day 5 (IgM or IgG detection):
ELISA, rapid tests, or hemagglutination
assay
36. A Case Presentation and Recap of Dengue 36
DF
•Fever with two or more of
the following: headache,
retro-orbital pain, myalgia,
arthralgia, rash, or
hemorrhagic
manifestations and no
evidence of plasma
leakage
Labs: leukopenia (≤ 5000
cells/mm3)
thrombocytopenia
(<150,000 cells/mm3),
and/or rising hematocrit
(5-10 percent)
WHO Grade I (DHF)
Above criteria and
hemorrhagic
manifestations plus
positive tourniquet test
and evidence of plasma
leakage
Labs: thrombocytopenia
(< 100,000) and
hematocrit rise 20% or
more
WHO Grade II (DHF)
Above criteria plus some
evidence of spontaneous
bleeding in skin or other
organs (black tarry stools,
epistaxis, bleeding from
gums, etc) and abdominal
pain
Labs: as above
WHO Grade III (DHF with DSS)
Above criteria plus
circulatory failure (weak
rapid pulse, pulse
pressure: 20 mmHg, or
high diastolic pressure,
hypotension with the
presence of cold clammy
skin, and restlessness)
Labs: as above
WHO Grade IV (DHF
with DSS)
Above criteria plus
profound shock with
undetectable blood
pressure or pulse
Labs: as above
38. A Case Presentation and Recap of Dengue 38
Tolerating oral intake of fluids, passing urine q6hr, and no
warning signs
Stable hematocrit:
send home
Encourage
ORS/fruit juices
Give paracetamol
PRN q6hr
Avoid ibuprofen and
other NSAIDs due
to risk of gastritis
and bleeding
Bring back if any of
the following occur:
• No clinical improvement
• Deterioration around the
time of defervescence,
severe abdominal pain
• Persistent vomiting,
• Cold and clammy
extremities, lethargy, or
irritability/restlessness
• Bleeding (e.g. black
stools or coffee-ground
vomiting)
• Not passing urine for
more than 4-6 hours.
41. A Case Presentation and Recap of Dengue 41
Initiate IV crystalloids 6
mL/kg/hr for 1-2 hr and
check Hct
Improvement: continue
IVF for 2-4 hr
Reduce to 3 mL/kg/hr for
2-4 hr
Reduce to 1.5-3 mL/kg/hr
for 2-4 hr
Stop IVF with further
improvement
No improvement
Hct rises
Increase IV to 10
mL/kg/hr for 2 hr
Check Hct
Hct falls: suspect internal
hemorrhage
Blood transfusion of 10
mL/kg whole blood or 5
mL/kg pRBC
IVF with crystalloids
reducing the flow from 10
to 3 mL/kg/hr and
discontinuation after 24-
48 hr
44. A Case Presentation and Recap of Dengue 44
Compensated
shock
IV crystalloids 10-
20 mL/kg/h for 1
hr
Improvement
Reduce IVF over
5-10 hr to reach
1.5-3 mL/hr
Discontinue IVF
with further
improvement
No improvement Check Hct
Rising or >45% Continue IVF
Falling: suspect
bleeding
Blood
transfusion/ABCS
/IV inotropes
45. A Case Presentation and Recap of Dengue 45
Profound shock
IV crystalloid
bolus 10-20
mL/kg over 15-30
min
Improvement
Reduce IVF over
5-10 hr to reach
1.5-3 mL/hr
Discontinue IVF
with further
improvement
No improvement
Repeat IV
crystalloids/colloid
s bolus; check Hct
Hct rising or
>45%
Continue IVF
Hct falling:
suspect bleeding
Blood
transfusion/ABCS
/IV inotropes
47. Definition
• A rare but potentially fatal disease of normal
but overactive histiocytes and lymphocytes
that commonly appears in infancy
• The pathologic hallmark is the aggressive
proliferation of activated macrophages and
histiocytes, which phagocytose RBCs, WBCs,
and platelets, leading to the clinical symptoms
• Rapid diagnosis and early treatment are
crucial
A Case Presentation and Recap of Dengue 47
48. Types
• Primary HLH is an inherited form, which is a
heterogeneous autosomal recessive disorder
• Secondary (acquired) HLH occurs after strong
immunologic activation, such as that which
can occur with systemic infection,
immunodeficiency, or underlying malignancy
• Both forms are characterized by the
overwhelming activation of normal T
lymphocytes and macrophages, invariably
leading to clinical and hematologic alterations
and death in the absence of treatment
A Case Presentation and Recap of Dengue 48
49. Secondary HLH
• Epstein-Barr virus is the pathogen that most
commonly triggers infection-associated HLH
• Although unusual, HLH may be a complication
of dengue and scrub typhus
A Case Presentation and Recap of Dengue 49
50. A Case Presentation and Recap of Dengue 50
Histiocyte
Society
Diagnostic
Criteria for
HLH
•Fever: seven or more days of a
temperature as high as 38.5°C
(101.3°F)
•Splenomegaly: a palpable spleen
greater than 3 cm below the costal
margin
•Cytopenia: counts below the specified
range in at least 2 of the following cell
lineages
•ANC < 1000/µL
•Platelet count < 100,000/µL
•Hgb < 9.0 g/dL
•Hypofibrinogenemia or
hypertriglyceridemia
•Fibrinogen < 1.5 g/L or > 3 SDs below the
age-adjusted reference range
•Fasting triglycerides > 2 mmol/L or > 3 SDs
above the age-adjusted reference range
•Hemophagocytosis: must have tissue
demonstration from lymph node,
spleen, or bone marrow without
evidence of malignancy
51. Other Labs
• Ferritin may be observed as a marker for HLH,
with the serum levels paralleling the course of
the disease.
• Liver damage may also occur, as evidenced
by hyperbilirubinemia, hypoalbuminemia, and
elevated findings on liver function tests
including AST and ALT.
A Case Presentation and Recap of Dengue 51
52. Treatment
• Initial therapy in patients consists of etoposide
and dexamethasone for 8 weeks in varying
doses
• Antineoplastic agents: etoposide and
methotrexate
• Corticosteroids: dexamethasone
• Immunosuppressants: cyclosporin
• Immunomodulators: emapalumab
• IV immunoglobulins
A Case Presentation and Recap of Dengue 52
53. References
A Case Presentation and Recap of Dengue 53
• Park K. Arthropod-borne infections. In: Parks Textbook of Preventive
and Social Medicine. 25th edn. Jabalpur: M/S Banarsidas Bhanot
Publishers. 2014. Pp. 269–279.
• Scriptable by Nature Education. Host Response to the Dengue Virus.
2014. Available from: https://www.nature.com/scitable/topicpage/host-
response-to-the-dengue-virus-22402106/ [accessed 20 Sep 2022].
• Schwartz RA. Lymphohistiocytosis (Hemophagocytic
Lymphohistiocytosis). In Coppes MJ (ed), Medscape. 2021. Available
from: https://emedicine.medscape.com/article/986458-overview
[accessed 20 Sep 2022].
• Pal P, Giri PP, Ramanan AV. Dengue Associated Hemophagocytic
Lymphohistiocytosis: A Case Series. Indian Pediatrics. 15:469-467.
2014.