Department of health and human services centers for. Guidelines for treatment of dengue feverdengue hemorrhagic fever in. 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. Dengue shock syndrome dss is defined as dhf with signs of circulatory failure, including a narrow pulse pressure pdf on apr 1, 2014, d.
The dengue shock syndrome dss is characterized by bleeding that may appear as tiny spots of blood on the skin petechiae. Dengue haemorrhagic fever dhf and shock syndrome dss. Dengue fever,dengue shock syndrome linkedin slideshare. Older children and adults may have either a mild febrile syndrome or the classic incapacitating disease with high fever of abrupt onset. Dengue fever is an acute, febrile, flu like illness caused by the dengue. The dengue shock syndrome dss is characterized by bleeding that may appear as tiny spots of blood on the skin petechiae and larger patches of blood under the skin ecchymoses.
Dengue syok sindrom dss adalah kasus deman berdarah dengue disertai dengan manifestasi kegagalan sirkulasi syok renjatan. Among these, there are 200,000 to 500,000 cases of potential lifethreatening dengue hemorrhagic fever dhfdengue shock syndrome dss, characterized by thrombocytopenia and increased vascular permeability. Jul 15, 2009 based on a clinical diagnosis of dengue shock syndrome dss plus myocarditis, dobutamine and noradrenaline infusions were started. 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. Dhf is a potentially deadly complication with symptoms similar to those of dengue fever, but. 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. Fluids were given with caution, and fresh frozen plasma ffp and platelet transfusion was commenced. Dengue hemorrhagic fever dhf is caused by the same viruses and is characterized by increased vascular permeability, hypovolaemia and abnormal blood clotting mechanisms. Dengue information disease surveillance epidemiology. Dengue shok syndrome dss adalah sindroma syok yang terjadi pada penderita dengue hemorrhagic fever dhf atau demam berdarah dengue dbd. Symptoms of dengue can become severe within a few hours. Dec 22, 2011 the symptomatic cases are categorized as undifferentiated febrile illness uf, dengue fever df, dengue hemorrhagic fever dhf, dengue shock syndrome dss and unusual dengue ud or expanded dengue syndrome eds. Abdominal ultrasound and computerized tomography confirmed acute pancreatitis. Dengue, dengue haemorrhagic fever and dengue shock.
Dengue shock syndrome dss has all of criteria for dhf plus circulatory failure as evidenced by. Clinical and laboratory features, progress and outcome of these patients were analysed in order to identify risk factors associated with development of dengue haemorrhagic fever dhf and dengue shock syndrome dss. A syndrome due to the dengue virus that tends to affect children under 10, causing abdominal pain, hemorrhage bleeding and circulatory collapse shock. Dengue, dhfdengue hemorrhagic fever, dssdengue shock syndrome.
Lovera and others published clinical characteristics of dengue shock syndrome dss in children find, read and cite all the research you need on researchgate. Most primary infections cause a debilitating, but nonfatal, form of illness. In a small proportion of cases, the disease develops into severe dengue, also known as dengue. As the disease spreads to new geographical areas, the frequency of the outbreaks is increasing along with a changing disease epidemiology.
The term dengue shock syndrome dss is used when an infected person has gone into shock. The morbidity and mortality from dss can be decreased by early diagnosis of shock and adequate replacement of plasma loss. Dengue shock syndrome dss is the final stage of the more severe occurrence of dengue dengue haemorrhagic fever dhf, and is fatal without prompt treatment. Current and historical conditions indexed list of current and historical nationally notifiable conditions. Dengue shock syndrome dss is defined as dhf with signs of circulatory failure, including a narrow pulse pressure shock. Dengue fever treatment as with most viruses, treatment options for dengue will only manage its symptoms. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a. 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. There are four dengue virus denv types denv1, denv2, denv3, and denv4, all of which are capable of inducing severe disease dengue hemorrhagic fever dhfdengue shock syndrome dss.
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. Aggressive management of dengue shock syndrome may. Pdf characteristics of dengue shock syndrome dss patients. Some patients, particularly children, experience a more severe and occasionally fatal form of the disease, called dengue haemorrhagic fever dhf, the most severe form of which is referred to as dengue shock syndrome dss. Patients can recover following appropriate medical treatment. Dengue shock syndrome is a presentation of dengue syndromes when there are criteria of dhf plus signs of circulatory failure, manifested by. Serotype infectivity and phylogenetic of dengue virus cause of dengue fever df, dengue hemorrhagic fever dhf, and engue shock syndrome dss in surabayaindonesia 1,5 infection with denv causes a spectrum of clinical disease ranging. Management of cardiorespiratory collapse in dengue shock syndrome references 12 dengue. Based on a clinical diagnosis of dengue shock syndrome dss plus myocarditis, dobutamine and noradrenaline infusions were started. Dengue is a febrile illness caused by a flavivirus transmitted by aedes aegypti or aedes albopictus mosquitoes while taking a blood meal. 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.
Infants and young children may have an undifferentiated febrile disease, often with a maculopapular rash. Virus dengue termasuk group b arthropod borne virus arbovirus dan sekarang dikenal sebagai genus flavivirusfamily flaviviridae yang mempunyai 4 jenis serotype yang diberi nama den1,den2,den3,dan den4. 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. Older children and adults may have either a mild febrile syndrome.
Guidelines for diagnosis, treatment, prevention and control. Dengue is a leading cause of illness and death in tropical and subtropical areas. The disease can have severe manifestations, including dengue hemorrhagic fever dhf and dengue shock syndrome dss. Acute pancreatitis with new onset diabetes in dengue shock syndrome dss is very rarely reported. Clinical manifestations and management of denguedhfdss.
Pdf serotype infectivity and phylogenetic of dengue. Oct 23, 2016 dengue shock syndrome dss is the final stage of the more severe occurrence of dengue dengue haemorrhagic fever dhf, and is fatal without prompt treatment. The list of acronyms and abbreviations related to dss dengue shock syndrome. The common severe syndromedengue haemorrhagic feverdengue shock syndrome dhf dss is characterised by sudden vascular permeability generated by cytokines released when t cells attack dengueinfected cells. There was a statistically significant difference in acidosis, ptt and hospital stay between the two groups. Summary dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity the cocirculation of multiple serotypes, and the emergence of dengue hemorrhagic fever in new geographic regions. Penyakit dengue shock syndrom dss adalah penyakit dhf yang mengalami renjatan atau shock mansjoer, arief. 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. Dengue and dengue hemorrhagic fever clinical microbiology. Evidence of circulatory failure manifested indirectly by all of the following. The morbidity and mortality from dss can be decreased by early diagnosis of shock and adequate replacement of.
They may range from subclinical infection to dengue fever, dengue hemorrhagic fever dhf, and eventually dengue shock syndrome dss. Dengue hemorrhagic feverdengue shock syndrome dhfdss is considered to be an antibodymediated viral disease, although this hypothesis remains. Dengue shock syndrome clinical sense medical joyworks. 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.
Dengue fever classical dengue fever or break bone fever is an acute febrile viral disease frequently presenting with headaches, bone or joint pain, muscular pains,rash,and leucopenia 7. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of. Dengue shock syndrome dss is defined as any case that meets the four criteria for dhf and has evidence of circulatory failure manifested by what to look for when you evaluate patients for dhf evaluate the patients heart rate, capillary refill, skin color and temperature. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Management of dengue haemorrhagic feverldengue shock syndrome. Denv2 with 89 whole genomes were obtained from patients diagnosed with dengue fever df, n58, dengue hemorrhagic fever dhf, n 30 and dengue shock syndrome dss, n1 during july 2010 to january 20 in singapore. Pdf serotype infectivity and phylogenetic of dengue virus. 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. Dengue shock syndrome dss must have 4 criteria for dhf and. Dhf may progress to hypovolemic shock known as dss. Thrombocytopenia and platelet transfusions in dengue. For example, two cases of dengue shock syndrome dss were recently described in swedish tourists returning from holiday in asia. 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.
Noting point is, in most people,dengue is less serious as. Hepatic dysfunction in children with dengue shock syndrome. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Description of the clinical picture of dengue hemorrhagic feverdengue shock syndrome dhf dss in adults. Known also as dengue hemorrhagic fever dhf, it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat. Lcs lum department of paediatrics, faculty of medicine, university of malaya, kuala lumpur introduction the major pathophysiology in dengue haemorrhagic fever dhf and dengue shock syndrome dss is an acute increase in vascular. The four dengue viruses are transmitted in tropical countries that circle the globe. Repeat platelet count was 22,000mm 3 and the hematocrit 48%.
Dengue shock syndrome an overview sciencedirect topics. Dengue shock syndrome oxford medical case reports oxford. Effectiveness of vitamin d in prevention of dengue. But since 1954, when dengue hem orrhagic fever dengue shock syndrome dhf dss was reported as a new phe nomenon in the philippines 2, it has. About 1 in 20 people who get sick with dengue will develop severe dengue. Dss is characterized by a massive increase in systemic capillary permeability with consequent hypovolemia. Dengue fever the clinical features of df frequently depend on the age of the. Infection may be asymptomatic or present with a broad range of clinical manifestations including a mild febrile illness to a lifethreatening shock syndrome. Dengue fever the clinical features of df frequently depend on the age of the patient. Despite the name, the critical feature that distinguishes dhf from dengue fever is not hemorrhaging, but rather plasma leakage resulting from increased vascular permeability. Risk factors associated with development of dengue. All can cause syndromes that are selflimited or severe.
The symptomatic cases are categorized as undifferentiated febrile illness uf, dengue fever df, dengue hemorrhagic fever dhf, dengue shock syndrome dss and unusual dengue ud or expanded dengue syndrome eds. Dengue shock syndrome dss this is the most serious manifestation of dengue and results in untreated patients or vulnerable children. Dengue fever is a disease caused by one of four related viruses transmitted to humans by the bite of an infected mosquito. Severe dengue is a more serious form of disease that can result in shock, internal bleeding, and even death. Abdominal pain, muscle pain, haemorrhage and four more signs that indicate dengue has progressed to dengue shock syndrome. The death rate associated with the more severe form dhf dss is approximately 5%, predominantly in children under the age of 15. It is important to increase awareness of dengue and dhf among physicians in temperate areas, however, because the disease can be lifethreatening. Rapid and weak pulse and narrow pulse pressure dss. Severe dengue is a more serious form of disease that can result in. Symptoms typically begin three to fourteen days after infection. Hepatic dysfunction in children with dengue shock syndrome dengue bulletin.
To study the characteristics of dengue shock syndrome dss patients managed during rawalpindi dengue epidemic 2014. Dengue shock syndrome dss is defined as any case that meets the four criteria for dhf and has evidence of circulatory failure manifested by. Summary much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. Management of dengue haemorrhagic feverldengue shock.
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