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Dengue Fever PowerPoint Presentation

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Description : Dengue Fever Clinical signs and symptoms By K.Lakshmi Prasanna

Tags : dengue,dengue fever,malaria,dengue disease,malaria disease

Published on : Apr 08, 2022 | Views : 6242 | Downloads : 24

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Dengue Fever Clinical signs and symptoms By K.Lakshmi Prasanna
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Most people with Dengue virus infection remain asymptomatic or develop only very minor symptoms. Only about 25% of the people infected experience a self-limited febrile illness, accompanied by mild to moderate haematological and biochemical abnormalities. Clinically relevant complications develop in a small proportion of the patients, which include a systemic vascular leak syndrome, coagulation abnormalities that can be associated with bleeding, and organ involvement, typically hepatic or neurological.
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Clinical phases After an incubation period of 4-7 days (maximum 14 days), symptoms typically begin abruptly and follow three phases. Febrile phase Critical phase Recovery phase
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Febrile phase It begins with sudden onset of high fever and chills – typically persistent or unremitting although a saddle back pattern can be observed. Fever lasts for 3-7 days from illness onset. Systemic symptoms such as headache, malaise, retro-orbital pain, arthralgia, myalgia, bone pain, nausea, vomiting and altered taste sensation. Examination findings can include rash, flush, conjunctival or pharyngeal injection, mild bleeding manifestations, generalised lymphadenopathy and a palpable liver.
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Critical phase Develops around the time of defervesence during which various complications occur. The various complications include: Vascular leak syndrome – Characterised by increased vascular permeability, plasma leakage and intravascular volume depletion which can progress to life threatening dengue shock syndrome. Plasma leakage can lead to hypoproteinaemia and serosal effusions. If leakage is severe, DSS can ensue characterised by hypotension with pulse pressure < or = 20mm Hg and rapid weak pulse.
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Bleeding – Minor bleeding is common – eg: skin petechiae, easy bruising, gingival, GI or PV bleeding – but not universal. Patients also have intrinsically lower platelet counts increasing the risk of bleeding with dengue. Liver impairment – Hepatomegaly and liver dysfunction are very common but rarely clinically important. AST titres typically exceed ALT titres. CNS impairment – Seizures, encephalitis, neuropathies , Guillain-Barre syndrome and transverse myelitis have all been reported.
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Cardiac impairment – Sinus bradycardia and minor or asymptomatic arrythmias are common. Eye impairment - Ocular manifestations include retinal haemorrhages, retinal oedema, macular ischaemia and optic neuritis. Patients usually complain of painless visual impairment, often around the time of platelet nadir. Impairment of other organs – Microscopic haematuria has been noted in 20-30% of patients with dengue. Renal failure is seen in profound DSS or in association with rhabdomyolysis.
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Recovery phase With good supportive care full recovery is usually within 1-2 weeks. The increased vascular permeability and abnormal are transient and resolve within 48-72 hours of becoming clinically apparent, but the individual often remains tired and lethargic for several days. A florid convalescent rash can develop resolving slowly over several weeks.
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Fever persisting for >10 days can indicate bacterial superinfection or development of rare complication such as secondary hemophagocytic lymphohistiocytosis. The recovery phase can be quite prolonged in adults , who can experience profound tiredness, weakness, myalgia and depression for weeks to months after the acute illness has resolved.
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Thank You