INTRODUCTION

Dengue is a mosquito-borne viral infection caused by the dengue virus

(DENV), transmitted primarily through the bite of infected Aedes aegypti mosquitoes.
These mosquitoes are identifiable by their white-striped legs and lyre-shaped
patterns on their thorax. Dengue can manifest in a range of symptoms, from mild
fever to severe complications such as dengue hemorrhagic fever and dengue shock
syndrome, which can be fatal without timely intervention. Common symptoms also
include: severe headache, pain behind the eyes, muscle and joint pains, nausea,
vomiting, and rash.
Dengue affects over 100 countries worldwide, with an estimated 390 million
infections annually, of which 96 million exhibit clinical symptoms. In 2024, the World
Health Organization (WHO) reported a continued rise in dengue cases globally,
particularly in tropical and subtropical regions such as Southeast Asia, due to factors
like urbanization, climate change, and increased human mobility. In the Philippines,
dengue remains a significant public health concern, particularly during the rainy
season. The Department of Health (DOH) recorded over 200,000 cases nationwide
in 2024, marking a 15% increase compared to the previous year. This increase is
attributed to favorable breeding conditions for mosquitoes, such as stagnant water
accumulation in urban and rural settings. Region 8, which includes provinces like
Leyte, Samar, and Northern Samar, reported over 10,000 dengue cases in 2024.
Among these, Catarman—the capital of Northern Samar—experienced one of the
highest case concentrations in the region. The town's geographical location and
seasonal rainfall contribute to the accumulation of stagnant water, creating ideal
breeding grounds for Aedes aegypti. Additionally, limited access to preventive
resources and public health infrastructure in some areas of Catarman has amplified
the challenge of controlling dengue outbreaks. Local health authorities have
emphasized the need for intensified efforts in vector control, community education,
and timely medical interventions to address the rising cases effectively.

Our group chose dengue as the focus of our case presentation because of its
significant public health impact, particularly in vulnerable communities like Catarman.
Traditionally, dengue cases peak between May and November during the rainy
season. However, due to climate change, rainfall has become more unpredictable
and evident year-round, creating continuous opportunities for Aedes aegypti
mosquitoes to breed and increasing the risk of outbreaks.

Dengue is preventable with adequate measures, yet it continues to claim lives

and strain healthcare systems. By highlighting this case, we aim to discuss the
critical role of healthcare professionals in prevention, education, and management
while emphasizing the importance of addressing climate-related health challenges.
As future nurses, we are committed to tackling diseases that pose substantial risks
to public health, particularly in our local communities, where awareness and timely
interventions are crucial.
Referrences:

European Centre for Disease Prevention and Control. (2024). Dengue monthly update.
Retrieved January 7, 2025, from https://www.ecdc.europa.eu/en/dengue-monthly

Statista. (2024). Number of dengue cases in the Philippines as of 2022, by region. Retrieved
January 7, 2025, from https://www.statista.com/statistics/1498116/philippines-number-dengue-
cases-by-region/

The Scottish Sun. (2025). Harrowing footage shows student, 22, ‘possessed’ after her ‘holiday
hangover’ turned out to be killer ‘breakbone fever’. Retrieved January 7, 2025, from
https://www.thescottishsun.co.uk/health/13013402/student-possessed-holiday-hangover-
dengue-fever-symptoms-bali/

COMPREHENSIVE HEALTH HISTORY:

Patient EY, a 7-year-old female from Barangay Poblacion, Rosario, born on

May 18, 2017, at Northern Samar Provincial Hospital (NSPH), is a Filipino child and
currently a Grade 2 student in primary school. She was rushed to the Emergency
Room (ER) on January 1, 2025, at 11:09 AM due to a high and recurring fever
lasting for three days.

She was attended to by Dr. Luzano and Dr. Marino. According to the mother,
they had previously visited the ER, where the child tested positive for dengue but
without any danger signs and was subsequently sent home. However, after several
days with the child still febrile, they returned to the ER. A repeat complete blood
count (CBC) was performed, revealing a platelet count of 77,000/mm³. The patient
was then diagnosed with dengue fever with warning signs and admitted to the
pediatric ward for further management.

Later, during hospital monitoring, the patient's fever had subsided, and her
vital signs were recorded as follows: temperature of 36.1°C, pulse rate of 90 bpm,
respiratory rate of 27 breaths per minute, and oxygen saturation of 99%
REVIEW OF SYSTEM

REVIEW OF SYSTEM
The patient’s usual weight ranges from 18 to 19 kg; however, it
General has decreased to 17.5 kg. The patient appears weak and exhibits
State low energy levels.

Rashes were observed on the patient's neck, chest, stomach,

Skin arms, and legs. The patient's skin appeared dry, and she reported
experiencing an itchy sensation around her stomach.

Chest Mild cough and crackles

Pulmonary

Breast/ Shortness of breath

Cardiac
The hematology analysis report indicates abnormalities, including
Hematology elevated eosinophil levels and decreased levels of neutrophils,
mean corpuscular hemoglobin (MCH), platelet count, platelet, and
platelet large cell count (PLCC).

Gordon’s Functional Health Management Pattern

 HEALTH PERCEPTION AND HEALTH MANAGEMENT PATTERN

The patient’s general health was described by her mother as not good, from
December 29, 2024, 3 days prior to her admission to the hospital because of her
condition she was rushed to the hospital. The mother stated that they previously
came to the ER due to a patient experiencing 3 days of fever, however they were
sent home after being tested with dengue with no danger sign. a patient attributes
staying at home “napuroko” as the primary method of maintaining her health. There
is no history of accidents or significant injuries. The mother believes that the current
illness resulted at their house while the patient is playing, where she might bitten by
mosquito with dengue virus led to the patient becoming sick and throbbing with
discomfort, prompting them to seek medical attention on January 1,2025

 NUTRITIONAL METABOLIC PATTERN

The patient is on DAT, and upon the assessment of her skin, there is a presence
of rashes all over the body, dryness and bony prominence . There are no reports of
dental issues as per assessing the patient. The patient's temperature upon
assessment was 37.3 degrees Celsius, and she is currently with ongoing PNSS
inserted at her right metacarpal hand.

 ELIMINATION PATTERN
Since January 1, the mother reported that the patient voided twice a day. On
January 6, she voided once in the morning . The stool characteristics are the color
green. She does not have difficulty with voiding and urination.

 ACTIVITY EXERCISE PATTERN

The mother stated that the patient is actively playing at their house and upon the
assessment she is easily destructed with gadgets.

 ACTIVITY AND EXERCISE PATTERN

Weak and lethargic due to his fever and lack of nutrition. Also experiencing body
malaise because of his high fever for 4 days. Needed assistance in simple activities
like walking or standing up. Decrease in muscle movements.

 SELF-PERCEPTION AND SELF-CONCEPT

The patient is still weak, and she looks anxious about her condition. Her major
concern is to have a fast healing.

 COPING AND STRESS TOLERANCE

Take a nap and rest when tired. And she uses gadget to ease the feeling of
boredom
She also verbalized the desire to get better.

 ROLE-RELATIONSHIP PATTERN
Patient is being taken care of by his mother. Well supported by his family members.

 VALUE AND BELIEFS

No restrictions to any procedures or treatment because of religion. And she Prays a
lot.
DIAGNOSTIC TEST:

SEROLOGY/IMMUNOLOGY

DENGUE DOU

Dengue NS1 Antigen Positive

IgG Positive

IgM Negative

INTERPRETATION OF PARAMETER:

Abnormal Findings:

LAB RESULT REF. UNIT IMPLICATION

VALUES RANGE

Neu% 30.0 50.0- % Neutrophils are crucial for

(Neutrophils (Slightly 70.0 fighting bacterial infections. A
Percentage) Low) slightly low count might suggest
a recent or mild infection,
possibly resolving or a transient
immune suppression. This could
make the individual slightly more
susceptible to bacterial
infections but is not critically
low.

Eos% 5.9% 0.5-5.0 % Elevated eosinophils can

(Eosinophils (Elevated) indicate allergies, asthma, or
Percentage) parasitic infections.

MCH (Mean 26.8 pg 27.0- pg MCH indicates the average

Corpuscular (Slightly 34.0 amount of hemoglobin per RBC.
Hemoglobin) Low)

PLT (Platelet 86 (Low) 100- 10³/µL Low platelet count can increase
 Count) 300 the risk of bleeding.

PDW 19.0 9.0 – fL Elevated PDW indicates

(Platelet (Elevated) 17.0 increased variability in platelet
Distrubution size.
Width

PCT 0.079% 0.108- % Low PCT reflects a reduced total

(Plateletcrit) (Slightly 0.282 mass of platelets in the blood.
Low) This can occur with:
o Low platelet count
(thrombocytopenia),
as seen in this
report.
o Reduced platelet
production or
increased platelet
destruction.
o It suggests a
decreased ability of
the blood to clot,
raising the risk of
bleeding.
o This can be an early
indicator of
conditions affecting
platelet production
or survival.

PLCC 29 30-90 10⁹/L A reduced number of larger,

(Platelet (Slightly younger platelets in the
Large Cell Low) bloodstream.
Count)

o Reduced platelet production

in the bone marrow.
o Increased platelet destruction
or consumption, possibly due
to an immune process or an
underlying condition affecting
platelet lifespan.
o Bone marrow suppression or
recovery following an insult
such as infection,
inflammation, or medication
 effects.
o Since larger platelets are
typically more functional and
younger, a slightly low PLCC
could suggest a slower
turnover or fewer new
platelets being released into
the circulation.
o It may also correlate with
overall thrombocytopenia
(low platelet count),
contributing to a higher risk
of bleeding or bruising.

PROGNOSIS

The prognosis for my 7-year-old female patient diagnosed with mild dengue and
presenting with rashes is as follows:

With supportive care, including intravenous hydration with 0.9% sodium chloride and
symptom management—such as paracetamol for fever, vitamin C syrup to support
immunity and nutrition, ambroxol to aid in clearing mucus from coughing, and
cefuroxime to address any bacterial infections—the prognosis is generally favorable.
Recovery is expected within 1–2 weeks with continued adherence to the prescribed
management plan.