Crystalloid fluid resuscitation and standard dic treatment are critical to the childs survival. Severe dengue is a more serious form of disease that can result in shock, internal bleeding, and even death. In a small proportion of cases, the disease develops into severe dengue, also known as dengue. Dengue fever is classically a selflimiting, nonspecific illness characterized by. Duque explained that the dengue shock syndrome is a grade four classification, according to the world health organization. Dengue haemorrhagic fever dhf and shock syndrome dss. A child with dengue hemorrhagic fever or dengue shock syndrome may present severely hypotensive with disseminated intravascular coagulation dic, as this severely ill picu patient did. Viral virulence, infection enhancing antibodies, cytokines and chemical mediators in the setting of intense immune activation are the key players implicated in the pathogenesis of dhf. Management of adult dengue shock syndrome patients not. Dengue shock syndrome clinical sense medical joyworks. Jun 09, 2016 dengue shock syndrome is the fourth clinical syndrome of dengue fever a sever form of dengue hemorrhagic fever 4 criteria for dhf evidence of circulatory failure manifested indirectly by all of the following. The capacity for oral infection and dissemination of two dengue type2 viruses, thnh793 and thnhpll93, isolated from patients exhibiting different disease severity, dengue shock syndrome dss. Some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and.
Dengue virus is a major public health concern across the globe. Infection may be asymptomatic or present with a broad range of clinical manifestations including a mild febrile illness to a lifethreatening shock syndrome. Management of dengue haemorrhagic feverdengue shock. The most urgent consideration is to establish intravenous access even though this can be difficult in a patient with poor peripheral circulation. Current and historical conditions indexed list of current and historical nationally notifiable conditions. Dengue shock syndrome public health medical specialties. Dengue chapter 4 2020 yellow book travelers health cdc. The management of dengue shock syndrome grade iii and iv is a medical emergency needing prompt and adequate fluid replacement for the rapid and massive plasma losses through increased capillary. Shock syndrome is a dangerous complication of dengue infection and is associated with high mortality. The viruses that cause dengue fever are related to those that. Previous infection with an alternative serotype allows antibody to the previously encountered serotype to combine with. The earliest evidence of possible benefit of corticosteroids in dengue came from a small randomized controlled trial, in which children with dengue shock syndrome were treated with a tapering dose of hydrocortisone for 3 days. Naides, in goldmans cecil medicine twenty fourth edition, 2012. The seminar addresses unusual manifestations of dengue infection, such as dengue fever with severe haemorrhage, hepatic damage, pulmonary effusion, congestive cardiac failure, and.
Abdominal ultrasound and computerized tomography confirmed acute pancreatitis. Dengue hemorrhagic fever dhf and dengue shock syndrome dss occur as seasonal epidemics in the tropics and are important causes of death in asian children. The four dengue viruses are transmitted in tropical countries that circle the globe. Dengue shock syndrome dss adalah sindrom syok yang terjadi pada penderita dengue hemorhagic fever dhf atau demam berdarah dengue. Symptoms of dengue can become severe within a few hours. Vitamin d serostatus and dengue fever progression to. Dss to dengue fever and undifferentiated febrile illnesses. In the past 30 years, dengue transmission and the frequency of dengue epidemics have increased greatly in most tropical countries in the american region. Dengue hemorrhagic feverdengue shock syndrome dhfdss is considered to be an antibodymediated viral disease, although this hypothesis remains. Known also as dengue hemorrhagic fever dhf, it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat. Dengue shock syndrome an overview sciencedirect topics. Salah satu kasus infeksi virus dengue dengan angka kematian paling tinggi adalah dengue shock syndrome dss, kirakira 7%.
Clinical findings include nausea, vomiting, rash, aches and pains, a positive tourniquet test, leukopenia. This is a less common manifestation of dengue, with about 500 000 cases per year and a case fatality rate of 15%, mainly affecting children. Case presentation on dengue fever, dengue shock syndrome 2. Rapid and weak pulse narrow pulse pressure jan 15, 2001 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 haemorrhagic fever dhf is a potentially deadly complication with symptoms similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. Around the time the fever begins to subside usually 37 days after symptom onset, the patient may develop warning. The symptoms of dengue hemorrhagic fever can trigger dengue shock syndrome. All can cause syndromes that are selflimited or severe. People with weakened immune systems as well as those with a second or subsequent dengue infection are believed to be at greater risk for developing. Symptoms typically begin three to fourteen days after infection. 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. As the disease spreads to new geographical areas, the frequency of the outbreaks is increasing along with a changing disease epidemiology.
Dengue viruses serotypes dengue 1 to 4 are flaviviruses associated primarily with febrile illnesses and rash. Demam dengue dan dhf disebabkan oleh salah satu dari 4 serotipe virus yang berbeda antigen. In november 2009, the world health organization who issued a new guideline that classifies symptomatic cases as dengue or severe dengue. The illness often begins with a sudden rise in temperature accompanied by facial flush and other flulike symptoms. 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. On friday, 29yearold k rajni from sainagar colony in saroornagar, hyderabad became the latest victim to dengue, reportedly dying of dengue shock syndrome soon after she gave birth to twin babies. A syndrome due to the dengue virus that tends to affect children under 10, causing abdominal pain, hemorrhage bleeding and circulatory collapse shock. Dengue hemorrhagic fever, dengue shock syndrome, severe dengue, vitamin d, vitamin d binding protein. Dengue shock syndrome free download as powerpoint presentation. Known also as dengue hemorrhagic fever dhf, it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea. Pdf 94777975 laporan kasus dengue shock syndrome rydell.
The reemergence of dengue virus resulted in increased morbidity and mortality. Dengue fever is a common mosquitoborne illness in many tropical and subtropical countries. Jadi kalau kamu dapat 15 pasien dss dalam sebulan, kemungkinan yang meninggal adalah 1 orang. Dengue haemorrhagic fever, dengue shock syndrome, risk factors, predictor, haematocrit introduction dengue fever is an endemic infective disease in malaysia. Dengue shock syndrome with retroperitoneal haematoma. It is occasionally accompanied by a shock syndrome, known as dengue shock syndrome, with a case fatality rate of 50%. Aggressive management of dengue shock syndrome may decrease. Thrombocytopenia and platelet transfusions in dengue. Pathogenesis of dengue haemorrhagic fever and its impact. Dengue hemorrhagic fever and dengue shock syndrome some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and sometimes fatal form of the disease. Dengue hemorrhagic fever and dengue shock syndrome. Known also as dengue hemorrhagic fever dhf, it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain.
Dengue fever, dengue haemorrhagic fever and dengue shock syndrome of infection is distinct clinical forms which is caused by dengue virus that belong to a member of the flaviviridae. Serum fatty acids and progression from dengue fever to dengue. Dss is characterized by a massive increase in systemic capillary permeability with consequent hypovolemia. Shock dengue shock syndrome and hemorrhage dengue hemorrhagic fever occur in less than 5% of all cases of dengue. Severe dengue occurs as a result of secondary infection. Dengue has emerged as important healthcare issue in pakistan during last two decades. Severe dengue occurs as a result of secondary infection with a different virus serotype. Dengue shock syndrome bukan saja merupakan suatu permasalahan kesehatan masyarakat yang menyebar dengan luas dan tibatiba, tetapi juga merupakan suatu permasalahan klinis, karena 3050% penderita demam berdarah. 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. The morbidity and mortality from dss can be decreased by early diagnosis of shock and adequate replacement of plasma loss. Dengue hemorrhagic fever and dengue shock syndrome some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and sometimes fatal form of the. Pdf dengue fever is a mosquitoborne arthropodborne viral arboviral tropical disease in humans affecting 50528 million people.
Dengue shock syndrome oxford medical case reports oxford. The mosquito aedes aegypti is the main vector of transmission of dengue virus in countries lying between latitudes. In addition, some patients with severe illness requiring. Although the mortality rate from all forms of treated dhf ranges from 1% to 26%, the mortality rate of severe dss may approach 47%, with one study reporting survival of only one of three children with dss and acute respiratory. Guidelines for diagnosis, treatment, prevention and control. Dengue is a febrile illness caused by infection with one of four dengue viruses denv transmitted by aedes aegypti or aedes albopictus mosquitoes during the taking of a blood meal. Acute pancreatitis with new onset diabetes in dengue shock syndrome dss is very rarely reported. Severe dengue, including dengue hemorrhagic fever or dengue shock syndrome, is characterized by severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums dengue is a mosquitoborne flavivirus found in tropical and subtropical regions of the world, mostly in urban and semiurban settings. Chapter 2 clinical diagnosis dengue virus infections may be asymptomatic or may lead to undifferentiated fever, dengue fever df or dengue haemorrhagic fever dhf with plasma leakage that may lead to hypovolaemic shock dengue shock syndrome, dss figure 2. Itu adalah gambaran kalau pasien diterapi secara adekuat. You are more likely to develop severe dengue if you have had a dengue infection before. Plasma leakage and intrinsic coagulopathy are the pathological hall marks in dengue haemorrhagic fever dhf.
Malaysia reported its first case of df in 1902 and dhf in 1962. Dengue hemorrhagic fever chapter 389 and dengue shock syndrome are forms of dengue reinfection characterized by capillary leakage and hemorrhage. The capacity for oral infection and dissemination of two dengue type2 viruses, thnh793 and thnhpll93, isolated from patients exhibiting different disease severity, dengue shock syndrome. Dengue hemorrhagic fever dhf and dengue shock syndrome dss are among the leading causes of pediatric hospitalization in asia, with. We describe a case of 30yearold man admitted in intensive care unit and was diagnosed with dss with rtpcr, ns1 antigen and dengue igm antibody being positive. It is an arboviral infection caused by the family flaviviridae. Dengue fever also known as breakbone fever, is a mosquitoborne topical disease caused by the dengue virus dengue fever, a benign syndrome caused by several arthropodborne viruses dengue fever 3. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. About 1 in 20 people who get sick with dengue will develop severe dengue. Dengue shock syndrome is the most serious manifestation of dengue hemorrhagic fever, a relatively new disease entity that has spread progressively throughout asia. Objectives early diagnosis pathophysiology of dhf proper management how to avoid complications case 07may18 ples slcp 2. Increased vascular permeability, together with myocardial dysfunction. Oct 23, 2016 on friday, 29yearold k rajni from sainagar colony in saroornagar, hyderabad became the latest victim to dengue, reportedly dying of dengue shock syndrome soon after she gave birth to twin babies. Menurut kriteria who tahun 1997 dinyatakan sebagai dhf derajat iiiiv.
Dengue haemorrhagic fever 12 chapter 2 clinical diagnosis dengue virus infections may be asymptomatic or may lead to undifferentiated fever, dengue fever df or dengue haemorrhagic fever dhf with plasma leakage that may lead to hypovolaemic shock dengue shock syndrome, dss figure 2. The term dhf suggests that hemorrhage is the cardinal manifestation of severe dengue. Dengue haemorrhagic fever dengue hemorrhagic fever dhf is caused by the same viruses and is characterized by increased vascular permeability, hypovolaemia and abnormal blood clotting mechanisms. Management of dengue haemorrhagic feverldengue shock syndrome.
Dengue shock syndrome and acute respiratory distress. Characterization of dengue shock syndrome in pediatric. Dengue fever,dengue shock syndrome linkedin slideshare. Dengue chapter 4 2020 yellow book travelers health. Jul 15, 2009 shock syndrome is a dangerous complication of dengue infection and is associated with high mortality. The first major outbreak of dengue haemorrhagic fever dhf. Dengue in the context of the imci i dengue, dengue haemorrhagic fever and dengue shock syndrome in the context of the integrated management of childhood illness department of child and adolescent health and development discussion papers on child health dengue in the context of the imci cah whofchcah05. Department of health and human services centers for. Dengue shock syndrome in an infant bmj case reports. A child with dengue hemorrhagic fever or dengue shock syndrome may present severely hypotensive with disseminated intravascular coagulation dic, as this severely ill pediatric icu patient did. Management of cardiorespiratory collapse in dengue shock syndrome references 12 dengue. Dengue shock syndrome is severe, and can lead to excessive bleeding and even death.
Vitamin d serostatus and dengue fever progression to dengue. Dengue shock syndrome dss is a major public health problem with high morbidity and mortality, especially in a case of prolonged shock with subsequently massive bleeding. Risk factors associated with development of dengue. Dengue fever the clinical features of df frequently depend on the age of the. Dengue, dengue haemorrhagic fever and dengue shock. Jose rigauperez and colleagues seminar sept 19, p 9711 on dengue and dengue haemorrhagic fever was timely and highlights the importance of this worldwide human viral disease transmitted by arthropod vectors. Dengue shock syndrome and acute respiratory distress syndrome. The common severe syndromedengue haemorrhagic feverdengue shock syndrome dhfdssis characterised by sudden vascular permeability generated by cytokines released when t cells attack dengueinfected cells. The four dengue viruses are unique among human pathogens in that the natural dengue immunity status can modify disease in two directions. Corticosteroids in the treatment of dengue shock syndrome. The seminar addresses unusual manifestations of dengue infection, such as dengue fever with severe haemorrhage, hepatic damage, pulmonary effusion, congestive. Patofisiologi yang utama pada dengue shock syndrome ialah reaksi antigenantibodi dalam sirkulasi yang mengakibatkan aktifnya system komplemen c3 dan c5 yang melepaskan c3a dan c5a dimana 2 peptida tersebut sebagai histamine tubuh yang merupakan mediator kuat terjadinya peningkatan permeabilitas dinding pembuluh darah yang mendadak sebagai akiba. Dengue shock syndrome is the most serious manifestation of dengue hemorrhagic fever, a relatively new disease entity that has spread progressively throughout asia and south america since its first.
This is the part of the blood that is first to come out of the blood vessels. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Dengue fever is a disease spread by the aedes aegypti mosquito and caused by one of four dengue viruses that are closely related. Comparison of three fluid solutions for resuscitation in. These two severe forms of dengue are observed in patients who undergo successive. Dhf is a potentially deadly complication with symptoms similar to those of dengue fever, but after several days the patient becomes irritable. Doc dengue shock syndrome stephanie mulyadi academia. One study estimated that 50 million infections occur every year.
220 1218 1522 1471 133 971 1084 1286 140 962 944 706 801 1052 1246 226 1263 232 1336 587 318 792 1264 1499 427 185 63 217 1353