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    Course of Illness:: Classification

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    Krista P. Aguinaldo
    Dengue fever is an acute febrile disease caused by the dengue virus and transmitted by the Aedes Aegypti mosquito. In the Philippines, there were over 80,000 reported cases of dengue in 2012. The disease progresses through three phases: fever, critical, and recovery. Symptoms include fever, headache, rash and bleeding. Treatment focuses on hydration and monitoring for warning signs like rapid heart rate or bleeding. Prevention methods promoted by the Department of Health include eliminating mosquito habitats, early medical care, self protection from bites, and limiting fogging.

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    Course of Illness:: Classification

    Uploaded by

    Krista P. Aguinaldo
    189 views2 pages
    Dengue fever is an acute febrile disease caused by the dengue virus and transmitted by the Aedes Aegypti mosquito. In the Philippines, there were over 80,000 reported cases of dengue in 2012. The disease progresses through three phases: fever, critical, and recovery. Symptoms include fever, headache, rash and bleeding. Treatment focuses on hydration and monitoring for warning signs like rapid heart rate or bleeding. Prevention methods promoted by the Department of Health include eliminating mosquito habitats, early medical care, self protection from bites, and limiting fogging.

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    Dengue pedia

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    dengue-for-oral-revalida-1

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    Dengue fever is an acute febrile disease caused by the dengue virus and transmitted by the Aedes Aegypti mosquito. In the Philippines, there were over 80,000 reported cases of dengue in 2012. The disease progresses through three phases: fever, critical, and recovery. Symptoms include fever, headache, rash and bleeding. Treatment focuses on hydration and monitoring for warning signs like rapid heart rate or bleeding. Prevention methods promoted by the Department of Health include eliminating mosquito habitats, early medical care, self protection from bites, and limiting fogging.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    189 views2 pages

    Course of Illness:: Classification

    Uploaded by

    Krista P. Aguinaldo
    Dengue fever is an acute febrile disease caused by the dengue virus and transmitted by the Aedes Aegypti mosquito. In the Philippines, there were over 80,000 reported cases of dengue in 2012. The disease progresses through three phases: fever, critical, and recovery. Symptoms include fever, headache, rash and bleeding. Treatment focuses on hydration and monitoring for warning signs like rapid heart rate or bleeding. Prevention methods promoted by the Department of Health include eliminating mosquito habitats, early medical care, self protection from bites, and limiting fogging.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    DENGUE FEVER

    • An acute febrile mosquito-borne tropical disease caused by the


    dengue virus.
    • Vector: female Aedes Aegypti.
    EPIDEMIOLOGY:
     Case of dengue in the Philippines as of 2012: 80,742. (DOH)
    Pathophysiology:

    Classification:

    Course of illness:

    Classification:
     History/PE
    o Take note the date of onset of fever/illness.
    o Warning signs
    o Mental status
    o Tourniquet test
     Laboratory:
    o CBC
    o UA
    o AST, ALT
    o Chest x ray
    o If with bleeding: PT, APTT.

    Management:
    Dengue Fever without Danger Signs

    General measures:
    -Bed Rest
    -Suficient fluid intake
    -Paracetamol as needed

    o Patient with stable hematocrit can be sent home, advise for


    return to hospital of with development of warning sign.
    o Monitor regularly for signs of progressing disease, improving WBC
    count, deverference, warning signs until out of critical phase

    Dengue Fever with Danger Signs

    Adequate hydration:

    o Encourage OFI if tolerated


    o If not, start IVF
    o Initial 5-7 ml/kg/hr for 1-2 hours
    o Reduce to 3-5 ml/kh/hr for 2-4 hrs
    o Reduce further to 2-3 ml/kg/hr or less based on clinical
    response.

     If HCT remains the same or rises minimally, continue with 2-3


    Course of illness: ml/kg/hr for another 2-4 hours

    LLOYD F. ALIAS
    #Matatag 2016
     If worsening of vitals and rapidly rising Hct, increase rate to 5-10
    ml/kg/hr, for 1-2 hrs

     Reduce IVF gradually until adequate UO and/or fluid intake or Hct


    decreases below baseline.
    DIFFRENTIAL DIAGNOSIS
    Monitoring:
    • Malaria - Malaria is caused by a parasite that is passed from one
    o Baseline Hct then every 6-12 hrs human to another by the bite of infected Anopheles mosquitoes.
    o Serum glucose and other tests for organ function
    Points to support Points to against
    Severe Dengue
     Endemic in the  Remittent fever
    o Initial resuscitation: crystalloids at 5-10 ml.kg.hr for 1 hour Region  No Chills
    o If with improvement: May reduce IVF to 5-7 ml/kg/hr for 1-2  Fever  No seizures
     Headaches
    hours, 3-5 ml/kg/hr for 2-4 hrs and then reduced further
     Nausea and vomiting
    depending on hemodynamic status. IVF maintained over 24 to 48
     Body weakness
    hours.
    o If unstable: Recheck Hct after initial IV bolus
    o If Hct still high(>50 %), give a second bolus of crystalloid solution
    or 10-20 ml/kg/hr for 1 hour (if with improvement, reduce rate to • Typhoid Fever - also known as enteric fever, is a potentially fatal
    7-10 ml/kg/hr) multisystemic illness caused primarily by Salmonella enterica.
    o If Hct decreases, may indicate bleeding and need to crossmatch
    and tranfuse blood. Points to support Points to against

    Management of Hypotensive Shock:  Fever  (-) Rose spots


     Headache  Remittent fever
    o Resuscutation with crystalloid or colloid at 20 ml/kg bolus for 15  Malaise  (-) Diarrhea
    minutes  Abdominal pain and  (-)
    o If(+) improvement, give IVF: 10 ml/kg/hr for 1 hours then reduce tenderness Hematochezia
    gradually  Thrombocytopenia
    o If still unstable: check Hct, assess need for further fluid
    resuscitationn.
    • Letospirosis - Leptospirosis is a disease caused by bacteria
    PROGNOSIS:
    (Leptospira interrogans) that produce a wide range of symptoms
    • Death has occurred in 40–50% of patients with shock, but with
    adequate intensive care deaths should occur in <1% of cases Points to support Points to against

    CRITERIA FOR DISCHARGING INPATIENTS • Fever


    • Head ached
    • Absence of fever for at least 3 days without use of antipyretics or • Body weakness
    Cryotherapy • Loss of appetite
    • Return of appetite • Abdominal pain
    • Visible clinical improvement • Vomiting
    • Good urine output •
    • Stable hematocrit •
    • No respiratory distress from pleural effusion or ascites
    • Platelet count of more than 100,000 per mm3

    PREVENTION

    DOH program: 4S

    o Search and destroy


    o Seek early consultation
    o Self protection
    o Say no to indiscriminate fogging

    IMMUNIZATION

    LLOYD F. ALIAS
    #Matatag 2016

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