Scribd
Upload
8 views4 pages

Guidelines Dengue

Uploaded by

Hadiya Rohit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
8 views4 pages

Guidelines Dengue

Uploaded by

Hadiya Rohit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

Guidelines for Clinical Management of Dengue Fever

Case definition
Probable DF/DHF:

A case compatible with clinical description (Clinical Criteria) of dengue


Fever during outbreak.:

OR

Non-ELISA based NS1 antigen/IgM positive.

(A positive test by RDT will be considered as probable due to poor


sensitivity and Specificity of currently available RDTs.)
Confirmed dengue Fever:

A case compatible with the clinical description of dengue fever with at least
one of the following

• Isolation of the dengue virus (Virus culture +VE) from serum, plasma,
leucocytes.
• Demonstration of IgM antibody titre by ELISA positive in single serum
sample.
• Demonstration of dengue virus antigen in serum sample by NS1 -ELISA.
• IgG seroconversion in paired sera after 2 weeks with Four fold increase
of IgG titre.
• Detection of viral nucleic acid by polymerase chain reaction (PCR).

Clinical Management
Approach to clinical management of dengue Fever may vary depending on
severity of illness. The patients who have simple fever without any danger
signs or complications may be managed with symptomatic approach. Those
who have warning signs and symptoms should be closely monitored for
progression of disease. The patients with grade III and IV of DHF,
significant bleeding or involvement of various organs require aggressive
management to reduce morbidity and mortality. Patient may develop
complications during later stage of fever (defervescence) or afebrile phase,
where clinician should be careful to look for danger signs and signs of fluid
overload.

Management of dengue Fever (DF)

Management of dengue fever is symptomatic and supportive

1. Bed rest is advisable during the acute phase.

2. Use cold/tepid sponging to keep temperature below 38.5° C.

3. Antipyretics may be used to lower the body temperature.


4. Aspirin/NSAIDS like Ibuprofen, etc should be avoided since it
may cause gastritis, vomiting, acidosis, platelet dysfunction and
severe bleeding. Paracetamol is preferable in the doses given
below:

• 1-2 years: 60 -120 mg/dose


• 3-6 years: 120 mg/dose
• 7-12 years: 240 mg/dose
• Adult : 500 mg/dose

Note: In children the dose of paracetamol is calculated as per 10 mg/Kg


body weight per dose. Paracetamol dose can be repeated at the intervals of
6 hrs depending upon fever and body ache.

5. Oral fluid and electrolyte therapy is recommended for patients


with excessive sweating or vomiting.

6. Patients should be monitored for 24 to 48 hours after they


become afebrile for development of complications.

Note:

 The fluid replacement should be just sufficient to maintain effective


circulation during the period of plasma leakage.
 The recommended intravenous fluids are Normal saline, Ringers
Lactate or 5% DNS.
 One should keep a watch for Urine output, liver size and signs of
pulmonary oedema. Hypervolumea is a common complication.
 Normally intravenous fluids are not required beyond 36 to 48 hrs.
 Remember that ONE ML is equal to 15 DROPS. In case of micro drip
system, one ml is equal to 60 drops. (if needed adjust fluid speed in
drops according to equipment used).
 It is advised to start with one bottle of 500 ml initially, and order
more as and when required. The decision about the speed of IV fluid
should be reviewed every 1-3 hours. The frequency of monitoring
should be determined on the basis of the condition of the patient.

Indication of Platelet transfusion

1. Platelet count less than 10000/cu.mm in absence of bleeding


manifestations (Prophylactic platelet transfusion).
2. Haemorrhage with or without thrombocytopenia.

Packed cell transfusion/FFP along with platelets may be required in cases


of severe bleeding with coagulopathy. Whole fresh blood transfusion
doesn't have any role in managing thrombocytopenia.

Platelets can be classified as random donor platelets (prepared by buffy


coat removal method or by platelet rich plasma method), BCPP (buffy coat
pooled platelet) and single donor platelets (SDP) or aphaeretic platelets
(AP).

The details of the different platelet products are given at Annexure I I.

Vaccine for dengue infection

Till now there is no licensed vaccine available against dengue viral infection.
Several trials are ongoing in the world for the development of tetravalent
dengue vaccine. So far phase III trials of a recombinant, live attenuated
tetravalent dengue vaccine (CYD-TDV) has completed in Five Asian
countries in children which may be promising in preventing dengue infection
in near future.

For further information please refer to NVBDCP Dengue Clinical


Management Guideline-2014

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy