Dengue fever: symptoms and treatment


Dengue fever is an acute disease of a viral nature caused by the same-named bacterium and occurs with the manifestation of flu symptoms or the expression of a hemorrhagic rash. The main carrier of a pathogenic microorganism is a mosquito — infection can occur even with a single insect bite. Dengue fever more often affects two groups of people. The first — kids up to one year of life. They often diagnosed hemorrhagic type of disease. The second — children over three years old, having recovered the classical form. Immunity produced after recovery, short-term. It is formed only to the subtype of the virus, which provoked the progression of the disease. This means that if another type of virus is re-infected, the immune system will not react and the disease will develop again.

Because of the rather difficult procedure for establishing this diagnosis, the incidence of disease in the adult population and children can not be established. There is often Dengue fever in Thailand and other countries with subtropical and tropical climates.

The disease is characterized by a severe course: with the expression of severe fever, intoxication, inflammation of the lymph nodes, tenderness in the joints and muscles, both at rest and after physical exertion. The occurrence of bleeding and a specific rash indicates the progression of dengue hemorrhagic fever.

Diagnosis of this disease is carried out on the basis of clinical manifestations and results of blood tests. Special treatment for this disease is not currently developed, so therapy is based on eliminating or removing the intensity of expression of symptoms. The classic form of the disease is characterized by a favorable prognosis, but hemorrhagic is characterized by a high degree of lethality. There is no disease prevention.

Etiology

There are four types of Dengue virus. Each of them can cause any form of fever. The disease is transmitted through the bite of an infected mosquito. The incubation period ranges from three to fifteen days, after which the characteristic symptoms of Dengue fever begin to be expressed. At the initial stages, inflammation of the lymph nodes is observed. The longer the disease progresses, the more pronounced are signs such as hyperthermia and intoxication. In the end, several internal organs and systems of the body are affected. It is the organ damage that causes the secondary progression of Dengue fever.

The hemorrhagic form of Dengue fever arises from repeated infection in a few years in people who have previously suffered a classic form of ailment. The main difference between these two types of disease is that with hemorrhagic form the probability of developing a shock condition is great, which, in turn, is considered the main factor of high risk of death.

The fact that the virus can be transmitted to the fetus with blood flow through the mother’s placenta is confirmed.

Species

There are several forms of Dengue fever:


  • classic — differs benign course and without the development of symptoms of hemorrhage. A characteristic feature of this type of disease is a two-wave increase in the body temperature of the patient. At the end of the first day after infection, a sharp increase in temperature indicators is observed. On the third day, the temperature returns to normal, after which it again increases to critical levels. In addition, there are frequent and severe attacks of headache, the appearance of soreness in the joints and muscles. After about a week of the course of the disease, the elements of the rash appear that itch;
  • hemorrhagic — signs are redness and skin rash, a pain in the stomach, which is often accompanied by vomiting with blood. There is a high probability of severe fever, which means the manifestation of hemorrhagic rash on the mucous membranes and the development of a shock state. That is why untimely treatment can cause the death of a patient
  • atypical — similar symptoms are expressed as in the classical form, but there is no lesion of the lymph nodes, which is its main difference.

In addition, based on the intensity of symptoms, during diagnosis, you can determine the degree of Dengue fever:


  1. Beginning — the characteristic expression is not observed;
  2. Medium — characterized by fever and chills
  3. of moderate severity — spontaneous hemorrhages (intradermal, gingival or nasal), as well as heart rhythm disturbances and weak blood pressure values ​​are added to the symptoms of the previous stage. This stage is called shock syndrome Dengue ;
  4. Heavy is a strong shock. In this state, it is difficult or impossible to determine blood pressure indicators.

Symptoms

Symptoms of Dengue fever and the degree of their intensity depend on the form of the disease. Classical fever is characterized by such manifestations as:


  • weakness and lethargy of the patient
  • a two-stage increase in body temperature;
  • pronounced chills
  • persistent colds
  • redness of the eye mucosa
  • hypersensitivity to bright light
  • the onset of soreness not only in the joints and muscles, but also in the spine and limbs
  • Sleep disorder
  • Decrease or total absence of appetite
  • the appearance of an unpleasant bitter taste in the mouth
  • enlarged lymph nodes;
  • Emesis attacks
  • the formation of a rash on the chest and shoulder area, which can spread to the entire body and limbs. Eruptions are represented by spots of red hue, rising above the level of the skin.

In addition to the above symptoms, the shock syndrome is characterized by such signs as:






  1. the appearance of a spot rash in the area of ​​the bend of the knees and elbows, which after five days extends to the face and body
  2. profuse diarrhea;
  3. multiple episodes of vomiting;
  4. When palpation, an increase in liver size can be detected.

In cases of severe fever this form of fever begins to show pinpoint hemorrhages on the skin and mucous internal organs. Against the backdrop of shock there is:


  • a sharp drop in pressure;
  • impaired consciousness
  • bluish skin tone
  • cramps;
  • A weak or uncertain pulse.

The duration of the shock is not great. A person can die without competent treatment during the day. Significant improvement in the condition is observed after timely anti-shock procedures.

Complications

The classic form of Dengue fever rarely causes the progression of adverse effects. Often it can be myocarditis. But without the timely treatment of the hemorrhagic form, the following complications arise:


  1. brain swelling
  2. formation of thrombi
  3. encephalitis
  4. inflammatory process of the membranes of the spinal cord and brain
  5. pneumonia;
  6. Otitis
  7. a sharp drop in blood pressure due to the action of the toxin produced by the virus
  8. intrauterine fetal death
  9. spontaneous termination of pregnancy.

Diagnostics

The specialist’s suspicion of Dengue fever causes the presence of the most characteristic symptoms described above. In addition, the diagnosis of this disease involves the collection and evaluation of laboratory blood tests to detect the DNA of the virus (only in the first three days of the illness). The establishment of a subtype of the virus is necessary for the immediate prevention of further progression of fever, which consists in the injection of a human immunoglobulin, previously ill with the necessary subtype of the disease. The determination of antibodies in the blood to the viral pathogen is also performed.

Diagnosis of fever is based on virological and serological blood tests. But there is a likelihood of finding cross-reactions with other microorganisms. This can become a factor of false positive results. In addition, consultations of such specialists as an infectious disease specialist, epidemiologist, neurologist and obstetrician-gynecologist (in those situations when pregnant women become pregnant women) may be needed. With the development of a shock state — consultations of the resuscitator.

Treatment

Treatment of patients with Dengue fever is carried out only in a medical institution. There is no therapy to eliminate the cause of the disease, therefore these measures are aimed at reducing the level of manifestation of symptoms. In most cases, patients are prescribed:


  • antipyretic drugs
  • injections of water-salt solution or glucose
  • blood transfusion in cases of extensive hemorrhage, and also in cases when it is required to restore the normal level of erythrocytes and platelets
  • Anti-inflammatory substances, for example, corticosteroids
  • antibiotics — but only in cases of development of dangerous consequences.

With timely treatment, the classic form of fever ends in complete recovery. In cases of diagnosis of hemorrhagic form, the forecast is more sad. The process of recovery depends on the age group of the patient, the type of virus, and the timing of the initiation of therapy. The highest risk of death is observed in children under three years old.

Currently, the vaccine against Dengue fever is at the stage of clinical trials, which is why there is no specific prevention of the disease. The only thing that people can do on their own is to protect themselves and their homes as much as possible from the main vector of the disease — mosquitoes.