Clinial Manifestations of Dengue Fever

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Presentation Transcript

Clinical Manifestations of Dengue Fever/DHF/DSS : 

Clinical Manifestations of Dengue Fever/DHF/DSS Dr. S. Aswini Kumar. MD Professor of Medicine Govt Medical College Hospital Thiruvananthapuram 1

Dangerous Dengue : 

Dangerous Dengue Dengue classic Dengue Hemorrhagic Fever Dengue Shock Syndrome Death 2

Dengue is a scare! : 

Dengue is a scare! 3

Definition : 

Definition Acute febrile viral illness characterized by Fever Headache Bone pains Muscle pains Nausea & vomiting Maculopapular Rash Leucopenia & thrombocytopenia Hemorrhagic manifestations 4

Dengue Virus – Flaviviridae : 

Dengue Virus – Flaviviridae DEN 1 DEN 2 DEN 3 DEN 4 Infection with one serotype produces life long immunity But only temporary & partial immunity against other types 50nm 11Kb 4 SEROTYPES 5

Vector - Aedes Egypti Mosquito : 

Vector - Aedes Egypti Mosquito Otherwise called as Tiger Mosquitoes because of dark lines Once infected mosquito remains infected for life and able to transmit to susceptible individuals 6

How do you get it? : 

How do you get it? 7

Epidemiology : 

Epidemiology 250 250 Aedes.Aegypti is a tropical and subtropical species of mosquito 8

Dengue Epidemic – Every 2-3y : 

Dengue Epidemic – Every 2-3y 9

Cyclical pattern - transmission : 

Cyclical pattern - transmission Coincides with summer season Cool temperature affects mosquito survival 10

Transmission and Replication : 

Transmission and Replication 11

First Infection : 

First Infection 12

Second Infection : 

Second Infection 13

More serious infection : 

More serious infection Practically no antibodies are formed to neutralize the DEN 2 viruses 14

Infected monocytes : 

Infected monocytes  Vasoactive Mediators  increase Vasular Permiability 15

Immunity determination : 

Immunity determination 16

WHO Case Definition : 

WHO Case Definition 17

Dengue Clinical Syndromes : 

Dengue Clinical Syndromes 18

Clinical Spectrum : 

Clinical Spectrum Children, Travelers, Adults 19

Undifferentiated Fever : 

Undifferentiated Fever 20

Classical Dengue Infection : 

Classical Dengue Infection Generalized Maculo-papular Rash Characteristic of Dengue Fever; uncommon in DHF & DSS 21

Hemorrhagic Meanifestations : 

Hemorrhagic Meanifestations 22

Visible Petechiae in legs : 

Visible Petechiae in legs A common hemorrhagic manifestation of Dengue Fever 23

Clinical case definition for Dengue Hemorrhagic fever : 

Clinical case definition for Dengue Hemorrhagic fever 24

Polyserositis Common in DHF : 

Polyserositis Common in DHF Associated with Plasma Leakage 25

Temperature & Virus Positivity : 

Temperature & Virus Positivity The relation of fever, virus titer and antibody titer with time Anti Dengue IgM by Fever Day for 55 patients with Dengue IgM only reaches levels positive 2 to 3 days after the fever falls below 38°C. This is about the 6th day of illness 26

Four grades of DHF : 

Four grades of DHF 27

Dengue Hemorrhagic Fever : 

Dengue Hemorrhagic Fever 28

Thrombocytopenia in Smear : 

Thrombocytopenia in Smear Platelets are seen singly and the count is reduced 29

The Tourniquet Test for Dengue : 

The Tourniquet Test for Dengue May be mildly positive or neative in Severe case of DSS 30

Clinical case definition for Dengue Shock Syndrome : 

Clinical case definition for Dengue Shock Syndrome 31

Signs and Symptoms of encephalitis/encephalopathy : 

Signs and Symptoms of encephalitis/encephalopathy 32

Dengue Encephalopathy : 

Dengue Encephalopathy 33

Warning signs -Dengue Shock : 

Warning signs -Dengue Shock 34

Other Fevers for Diagnosis : 

Other Fevers for Diagnosis 35

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