Complications and Management of Dengue Haemorrhagic Fever

Definition of Dengue Haemorrhagic Fever (DHF):

According to WHO, dengue hemorrhagic fever is defined as “a dengue like illness with thrombocytopenia (100 x 10˄9/L) and a hemoconcentration (hematocrit elevated by 20%). It is a much more severe disease than classical dengue fever, with a fatality rate that approaches 10%.

dengue haemorrhagic fever
Fig: Dengue haemorrhagic fever

Management of Dengue Haemorrhagic Fever (DHF):

a) Management of DHF during the febrile phase is similar to that of dengue fever.

b) Oral electrolyte solution of fruit is juice is recommended during the febrile phase.

c) Monitor:

  • Platelet count and Hct value should be estimated at least daily.
  • Frequent recording of vital signs is recommended for adjusting replacement avoiding over hydration.

d) Fluid therapy: A rise of haematocrit of 20 or more indicates the need for IV fluids therapy.

  • Ringers lactate solution,
  • 9% W/V normal saline,
  • 5% dextrose in half strength normal saline solution.

e) Blood transfusion: In case of significant/ severe bleeding.

f) Shock: In case of shock give oxygen.

g) Acidosis: For acidosis use sodium bicarbonate.

h) Evaluation of patient’s condition:

  • Frequent recording of vital signs,
  • Pulse, BP, respiration and temperature every 30 minutes,
  • Monitoring of urine output,
  • Platelet court and haematocrit determination,
  • Haematocrit level 2 hours for first 6 hours then every 4 hours,
  • Fluid balance sheet.

Clinical Laboratory Investigation of Dengue Haemorrhagic Fever (DHF):

It includes the following:

  • Haematocrit – increase 20%,
  • Platelet count – Thrombocytopenia,
  • WBC count and DC,
  • Coagulograme: PT, partial thromboplastin time, fibrinogen level and fibrinogen degradate products,
  • Serum protein particularly albumin,
  • Liver function tests,
  • Serum electrolyte particularly sodium,
  • Blood gas analysis,
  • Renal function and urine examination,
  • Serum complements,
  • Stool examination OBT,
  • ECG,
  • Chest X-ray,
  • USG of abdomen,
  • Plus,
  • Diagnosis for dengue – virus isolation and serology (IgM and IgG).

Complications of Dengue Hemorrhagic Fever:

All the complications of dengue hemorrhagic fever have listed in the below:

1. Intracranial bleeding,

2. Encephalopathy,

3. Convulsions,

4. Renal failure,

5. Hepatic failure,

6. Hemolytic uremic syndrome,

7. Iatrogenic problems like-

More questions related to this article:

  • What is dengue haemorrhagic fever?
  • Outline the principles of management of dengue hemorrhagic fever.
  • How will you treat a case of dengue hemorrhagic fever?
  • Write down the management of dengue fever.
  • Discuss the management of dengue haemorrhagic fever.
  • Write down the clinical laboratory investigation of DHF.
  • What are the complications of dengue hemorrhagic fever?

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