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 ï‚® Vasoactive Mediators ï‚® 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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