Dengue fever medical therapy: Difference between revisions
Line 17: | Line 17: | ||
The presence of [[melena]] may indicate internal [[gastrointestinal]] bleeding requiring [[platelet]] and/or red blood cell transfusion. A [[platelet]] [[blood transfusion|transfusion]] may be indicated in rare cases if the [[platelet count]] drops significantly (below 20,000) or if there is significant bleeding. | The presence of [[melena]] may indicate internal [[gastrointestinal]] bleeding requiring [[platelet]] and/or red blood cell transfusion. A [[platelet]] [[blood transfusion|transfusion]] may be indicated in rare cases if the [[platelet count]] drops significantly (below 20,000) or if there is significant bleeding. | ||
==WHO | ==WHO Guidelines== | ||
The WHO recommends rapid screening and triage of patients into three groups: | The WHO recommends rapid screening and triage of patients into three groups: | ||
*Group C: Patients with severe dengue who require immediate emergency treatment to avert death | *Group C: Patients with severe dengue who require immediate emergency treatment to avert death |
Revision as of 14:23, 14 June 2014
Dengue Fever Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Dengue fever medical therapy On the Web |
American Roentgen Ray Society Images of Dengue fever medical therapy |
Risk calculators and risk factors for Dengue fever medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Currently, no effective antiviral agents are available to treat symptomatic dengue virus infection, and management remains supportive with emphasis on judicious fluid administration with oral rehydration solution or intravenous fluids. Acetyl-salicylic (aspirin) derivatives and other non-steroidal anti-inflammatory drugs should be avoided because of their potential to increase the risk of bleeding. Patients who have no complications and are able to tolerate oral fluids may be managed at home or as an outpatient. Development of any warning signs (See Group B or C below) suggests the need for intravenous fluid therapy and hospitalization. If the condition progresses to the Dengue shock syndrome, restoration of plasma volume with fluid boluses and/or blood transfusion is required to maintain adequate tissue perfusion.
General Measures
- Oral and intravenous fluids
- Avoid aspirin and non-steroidal anti-inflammatory medications. These drugs are often used to treat pain and fever though in this case they may actually aggravate the bleeding tendency associated with some of these infections. Patients should instead receive acetaminophen (tylenol) to deal with these symptoms [2] if Dengue is suspected.
Management of Complications
The presence of melena may indicate internal gastrointestinal bleeding requiring platelet and/or red blood cell transfusion. A platelet transfusion may be indicated in rare cases if the platelet count drops significantly (below 20,000) or if there is significant bleeding.
WHO Guidelines
The WHO recommends rapid screening and triage of patients into three groups:
- Group C: Patients with severe dengue who require immediate emergency treatment to avert death
- Group B: Patients with warning signs who should be given priority while waiting in the queue so that they can be assessed and treated without delay
- Group A: Patients who have neither severe dengue nor warning signs
Detailed criteria to triage patients and the appropriate management strategy are shown below (click to expand):[1][2]
|
|
|