Background: Fluid therapy for dengue shock syndrome (DSS) requires a dynamic approach that involves monitoring of the pathophysiological processes as well as the preload, contractility, and afterload assessment during the course dengue infection. dengue fever, expanded dengue syndrome and dengue shock syndrome: clinical profile, management and outcome of patients at a tertiary hospital, dhaka, bangladesh Article Full-text available Based mainly on expert opinion, WHO management guidelines for DSS recommend … Previous infection with an alternative serotype allows antibody to the previously encountered serotype to combine with the newly infecting serotype. dengue shock syndrome. 11 – 13 Much of the evidence points to severe manifestations of dengue having an … These guidelines were developed based on the best available evidence at the time of writing. Revised and expanded edition. With expert supportive care mortality rates have been reduced to very low levels, in many cen-tres of excellence down to less than 1 % for those with severe disease [3]. It may range from asymptomatic or self-limiting dengue fever (DF) to severe dengue characterized by plasma leakage (dengue hemorrhagic fever, DHF) and dengue shock syndrome (DSS). Thrombocytopenia was seen in 31 cases (70.4%) and 14 (31.81%) received platelets transfusions. Dengue haemorrhagic fever was seen in 15.9% and dengue shock syndrome in one fatal case (2.2%). Dengue haemorrhagic fever and dengue shock syndrome typically occur in children under the age of 15 years, although dengue fever primarily occurs in adults and older children. Fetal outcomes in our series were favourable, except for one stillbirth, with 45.4% preterm deliveries and 15.9% small for gestational age babies. Dengue Management DO’s and DON’Ts X DON’T use corticosteroids. By adeel rafi ahmed. This retrospective hospital-based study was conducted to evaluate the various risk factors associated with dengue shock syndrome (DSS) in patients (≤18 years of age) of dengue hemorrhagic fever (DHF). According to WHO guidelines, a pa-tient with dengue hemorrhagic fever is considered to have dengue shock syndrome once the pulse pressure narrows to 20 mm Hg or less. Although case s … One factor that is thought to cause the dreaded shock syndrome is antibody-dependent enhancement, resulting in increased viral replication; 3, 9, 10 however, many other virus and host factors are thought to contribute. Undifferentiated fever Those who have been infected with dengue virus, especially for the first time (i .e. Based mainly on expert opinion, WHO management guidelines for DSS recommend … The pathogenesis of severe dengue is poorly understood. A non-negligible proportion of febrile persons diagnosed with dengue infection (dengue fever, DF) progresses to severe forms of the disease, including dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Severe dengue, including dengue hemorrhagic fever or dengue shock syndrome, is characterized by severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, restlessness, and blood in vomit, and may be fatal due to plasma leakage, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Drugs & Calculators. 5 The main criticism of this recommendation is that it is based on poor-quality evidence, thus the interest in corticosteroids for treating dengue has continued. The factors that induce progression from dengue fever (DF) to these potentially fatal forms of the disease, including dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS), are uncertain. Hemodynamically unstable DSS patients received in referral setting often complicated by fluid overload and secondary infection. Expanded dengue syndrome (r are) Courtesy: comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever. It presents with acute onset of fever with nonspecific constitutional symptoms and signs of hemorrhagic diathesis, which may progress to fatal shock (Dengue shock syndrome, DSS). In 2019. outbreaks in Bangladesh, there were over 100,000 . CPG Dengue Infection PDF Final. Related Papers. It's widespread in many parts of the world. Dengue shock syndrome (DSS) - The patient is considered to have shock if the pulse pressure (i.e. Dengue is the most common mosquito-borne viral infection in the world. Author Summary Dengue is one of the most common viral diseases transmitted by infected mosquitoes. However, more patients with severe shock at presentation had required rescue colloids than did patients with moderately severe shock. Dengue is the most common mosquito-borne viral infection in the world. Furthermore, the study does not randomize patients with severe dengue shock syndrome to treatment with crystalloids because of concerns about the potential development of critical fluid overload without access to advanced respiratory support. In severe cases, the patient's condition may suddenly deteriorate after a few days of fever; the temperature drops, followed by signs of circulatory failure, and the patient may rapidly go into a critical state of shock. CLINICAL PRACTICE GUIDELINES. Severe Dengue includes plasma leakage and dengue shock syndrome, which are less quantitatively defined than DHF and DSS in the 1997 WHO Guidelines. By Shirley Dueñas Labán. Medical Calculators; Drug Calculators; Growth Calculators In dengue-endemic regions, the triage of patients with suspected dengue infection should be carried out in a specifically designated area of the hospital. As the disease spreads to new geographical areas, the frequency of the outbreaks has increased along with a rapidly changing disease epidemiology. Health and Knowledge with fun. Mosquitoes in the UK do not spread the dengue virus. There … 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. Dengue is a viral infection spread by mosquitoes. In most cases these symptoms resolve within one week, however a small proportion of patients develop complications that may include bleeding, organ dysfunction and a capillary leak syndrome that progresses to hypovolaemic shock in severe cases, i.e. Dengue Shock Sindrome. Dengue Shock Syndrome (DSS) All the above criteria of DHF plus signs of circulatory failure manifested by rapid and weak pulse, narrow pulse pressure (< or equal to 20 mm Hg); hypotension for age, cold and clammy skin and restlessness. DHF/dengue shock syndrome (DSS). The most feared complication is a poorly understood vasculopathy that occurs in only a small minority of symptomatic individuals, especially children and young adults, but can result in potentially fatal dengue shock syndrome (DSS). Pathogenesis of dengue. Garry Gabe. Platelet transfusions do not decrease the risk of severe bleeding and may instead lead to fluid overload and prolonged hospitalization. They are not indicated and can increase the risk of GI bleeding, hyperglycemia, and immunosuppression. Dengue hemorrhagic fever (Chapter 389) and dengue shock syndrome are forms of dengue reinfection characterized by capillary leakage and hemorrhage. Haemorrhagic Fever patients and replaces the existing national guidelines on clinical management of Dengue Fever / Dengue Haemorrhagic Fever published by Epidemiology Unit Ministry of Health in 2005. We report the case of a patient with dengue shock syndrome leading to acute liver failure and kidney injury, complicated with staphylococcal infective endocarditis and right proximal femoral deep vein thrombosis. The only recognised treatment is maintaining adequate hydration in dengue fever and fluid replacement therapy in dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). The reasons why some patients progress to these potentially fatal forms are poorly understood. Dengue hemorrhagic fever (Chapter 389) and dengue shock syndrome are forms of dengue reinfection characterized by capillary leakage and hemorrhage. Platelets as a drug target for Dengue Haemorrhagic Fever2 5 Repaired 4 1. Dengue is not included in the generic Integrated Management of Childhood Illness (IMCI) algorithm but it is an important differential diagnosis of fever in children presenting to first-level health facilities in tropical Asia and Latin America. DSS is characterized by a massive increase in systemic capillary permeability with consequent hypovolemia. Previous infection with an alternative serotype allows antibody to the previously encountered serotype to combine with the newly infecting serotype. (SEARO Technical Publication Series No. Medical records of these 483 patients with DHF (IgM serology positive) were analyzed with reference to shock for various clinical and biochemical parameters. Dengue infection is a major public health concern throughout India and every year cases are being seen in newer geographical areas.Multiple dengue guidelines pose a problem in diagnosing dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS), erroneously admitting many cases that overburdened Indians hospitals during epidemics, especially in resource-limited settings. Consultation with a critical care medicine specialist may be helpful when treating patients with dengue hemorrhagic fever or dengue shock syndrome and severe hemorrhagic manifestations or shock. By Israr Mohtar. The new case … A 38-year-old previously healthy Sri Lankan woman from Colombo, Sri Lanka presented to a teaching hospital on day 5 of an acute febrile illness. The article … From 1975 through 2009, symptomatic dengue virus infections were classified according to the WHO guidelines as dengue fever, dengue hemorrhagic fever (DHF), and dengue shock syndrome (the most severe form of DHF). Case presentation. X DON’T give platelet transfusions for a low platelet count. Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the world. Risk factors include secondary infections by new dengue serotypes and host's genetics It is caught by people visiting or living in Asia, the Americas or the Caribbean. Other severe complications, such as severe liver, cardiac or neurological involvement, may also occur but are less frequent. The third Edition of the 'National Guidelines for Clinical Management of Dengue Syndrome was updated in 2013 by the participation of internists, pediatricians, national control program personnel and researchers as a tool to provide an uniform, consensus, scientific, affordable and appropriate clinical management and removing prevailing confusions and ambiguity. Draft CPG Management of Dengue Infection in Adults (3rd Edition) 2015 CLINICAL PRACTICE GUIDELINES MANAGEMENT OF DENGUE INFECTION … 60) 2011 2.1. In dengue-endemic regions, suspected, probable, and confirmed cases of dengue infection should be reported to the relevant authorities as soon as possible. However, these risk factors may not be generalized to all populations and epidemics for screening and clinical management of patients at risk of developing DHF/ Dengue shock syndrome (DSS). resulting in life-threatening dengue shock syndrome (DSS). The above descriptions of DF/DHF/DSS are adequate for guiding doctors to treat the disease. Dengue hemorrhagic fever: Children less than 15 years are the most common victims. Dengue Syndrome (EDS) in its guidelines 2,6. The clinical manifestations of DENV infection range from an asymptomatic infection to a debilitating but self-limited illness termed dengue fever (DF), to more severe forms of the disease characterized by increased vascular permeability and plasma leakage, known as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) [2, 3]. the difference between the systolic and diastolic pressures) is ≤ 20 mm Hg in children and he/she has signs of poor capillary perfusion (cold extremities, delayed capillary refill, and rapid pulse rate). Based on the newer version … Severe dengue also includes several other clinical entities and endpoint diseases, some linked to the fundamental biology of dengue infections, others of iatrogenic origin, and others of as yet unknown pathogenesis. There has been no previous summary of existing dengue guidelines to explore their usefulness in the context of IMCI and to identify questions for research. They may involve secondary infections by new viral serotypes, agent virulence and host characteristics ( Reference Guzman, Alvarez and Halstead 3 ) . Important risk factors influencing who will develop dengue haemorrhagic fever or severe disease during epidemics include the virus strain and serotype, immune status of the host, age, and genetic predisposition. Although there is no specific treatment for dengue, … Dengue fever (DF): Incubation period is 4-6 days (3-14 days range). Death from dengue infection occurs mostly in DSS, and the mortality of DSS is reportedly 50 times … The most feared complication is a poorly understood vasculopathy that occurs in only a small minority of symptomatic individuals, especially children and young adults, but can result in potentially fatal dengue shock syndrome (DSS). The guidelines will be reviewed periodically when new evidence becomes available. While DF is a sim-ple, self-limited febrile illness, DHF is a severe and potentially life-threatening condition. Of the 2.5 billion people globally at risk of DF and its severe forms dengue haemorrhagic fever (‎DHF)‎ and dengue shock syndrome (‎DSS)‎ South-East Asia accounts for approximately 1.3 billion or 52%. Notifiable disease. A number of Dengue Haemorrhagic Fever (DHF) risk factors had been suggested. Corticosteroids are not recommended treatment in the WHO dengue guidelines.

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