A CASE PRESENTATION ON

DENGUE FEVER

A.Akshaya
22M710001
PHARMD-IIYR
 DETAIL ON DENGUE
 Definition : Dengue fever is a mosquito born viral infection caused by the dengue virus transmitted
primarily by Aedes mosquitoes.It is characterized by sudden on set of fever,severe headache,
muscle &joint pain,fatigue,nausea,vomit & skinrash .It can range from mild to severe &can
sometimes progress to dengue hemorrhagic fever a potentially life- threatening complication
characterized by severeheadache ,bleeding,plasmaleakage & organs impairment is called dengue
 Epidemology : Dengue fever is a significant global public health concern with an estimated
390million Dengue virus infections occuring annually world wide.The disease is endemic in over
100countries primarily In tropical and subtropical regions of world, including parts of south
eastern Asia,western Pacific,Africa, America & Eastern Mediterranean. Ades mosquitoes
particularly Ades aegypti and Ades albopidus are the primary vectors responsible for transmitting
the virus to humans. Dengue fever out breaks can occur seasonally in endemic areas, often
coinciding with rainy season.When mosquito populations increased.The risk of infection is higher in
urban & peri- urban are as with densely populated communities, in adequate sanitation & water
storage practices that creates breeding sites for mosquitoes.
 Pathophysiology :
 Etiology :Dengue fever is caused by the dengue virus, which is primarily transmitted through
the bite of infected Aedes mosquitoes, particularly Aedes aegypti. There are four serotypes of
the virus (DEN-1, DEN-2, DEN-3, and DEN-4), all of which can cause the disease.
Classification :
 Signs and symptoms : The characteristic symptoms of dengue are ; Sudden onset fever ,
headache, muscle & joint pains & rash.
 Incubation period – 5 to 7 days
 In small proportion of the disease devlops into life threatening DHA(dengue hemorrhagic
fever) resulting.
 Bleeding and low level of platelets,plasmaleakage, low blood pressure
 Diagnosis :Diagnosing dengue typically involves a combination of clinical assessment,
laboratory tests, and consideration of the patient’s symptoms and medical history. Common
diagnostic methods include blood tests to detect the dengue virus or antibodies produced by
the body in response to the infection. Symptoms such as fever, severe headache, joint and
muscle pain, rash, and bleeding may also aid in diagnosis. It’s essential to consult healthcare
professionals for accurate diagnosis and appropriate treatment.
PATIENT DEMOGRAPHIC
DETAILS :
 Name of patient : saroja
 Age :15years /female
 Ward : General medical ward-II
 Date of admission : 20-2-24
HISTORY OF PRESENT ILLNESS

 C/o fever, high grade fever since 3days

 c/o lower limb pain 2days
 No abdominal pain, vomitings ,no nausea condition
 constipation

 { No past medical history }

OTHER DETAILS :
Personal history :
Bowels – irregular
Family history :
Not significant
Physical examination :
Pulse – 105bpm
Blood pressure- 90/70mmhg
GRBS-142mg/dl
.
SYSTEMIC EXAMINATION
Cardio vascular system
. Heart sounds- S1S2 normal
Respiratory system
. Position of trachea – central
. Breath sounds – vesicular
Abdomen
. shape – scaphoid
Central nervous system
Level of conscious – conscious
Neck stiffness - no
PHYSICAL EXAMINATION
Vital Day 1 Day2 Day3 Day4 Day5 Day6 Day7
signs

Temp 105°F 104°F 100°F 98°F 98°F 98°F 98°F

:
B.P : 90/70 94/70 98/70 100/9 106/7 110/8 115/8
mmh mmh mmh 0mm 0mm 0mm 0mm
g g g hg hg hg hg
:
LABORATORY EXAMINATION
Parameters Observed value Normal value

Haemoglobin 13.1g/dl 11-16.5g/dl

Total count 1800cells/cum 8500-10000/cum

Differential count

Neutophils 74% 40-70%

Lymphocytes 20% 15-30%

Monocytes 2% 2-10%

Esinophils 4% 1-6%

Basophils 1-3%
PROVISIONAL DIAGNOSIS
 ∆sis.
 Dengue NS1ANTIGEN positive
 With Thrombocytopenia
 c/opetechiae over upper limbs and lower limbs
 Round spots on skin
TREATMENT
Generi Brand Dose Frequency ROA Day-1 Day Day-3 Day-4 Day-5
c name -2
name

Inj.ceftr 1-0-1
iaxone rocephi 60Mg IV + + + + +
n

Cap.Do 1-0-1
xycycli doryx
ne 100Mg PO + + + + +

Inj.pct Paracet
amol 1-1-1
COMPLICATIONS
SOAP NOTES
SUBJECT :
 c/o High grade fever
 C/o lower abdominal pain

OBJECTIVE :
 Temperature –105°F
 Blood pressure –90/70mmhg
 Petechiae noted on skin
 Platelet count-72000/cum
ASSESSMENT
 Based on chief complaints patients has confirmed as dengue fever
 By using laboratory investigations and parameters
 Inj.Ceftriaxone - To treat bacterial infections
 Cap.Doxycycline - To treat bacterial infections
 Syrup.Sucralfate - To treat and prevent duodenal ulcers and other conditionsSyrup.
 lactulose - Totreat constipation
 Inj.levosulpride - Totreat digestive issues
 T.udiliv - Totreat liver related disorders such as cirrhosis and sclerosingcholangities
 Inj.ondonetron - To prevent nausea and vomiting
PLAN
 Monitor vitalsigns and fluid intake
 Adminster paracetamol for fever and pain educate the patient on signs of bleeding and when to
seek medical attention
 Strict bedrest advised
 Monitor platelets count regularly
 Advice patient to avoid NSAIDS due to risk of bleeding
 Inj.ceftriaxone
 Class : cephalosporin antibiotics
 MOA : Inhibition of bacterial cell wall synthesis
Cap.Doxycycline
 Class : Tetracycline antibiotics
 MOA : Intended to stop growth of bacteria by allosterically binding to the 30s prokaryotic ribosomal unit during protein synthesis
Syrup.Sucralfate
 Class. : Protectants
 MOA. : Bind positively charged proteins in exudates locally forming a thick forming a thick viscous substance
Syrup.lactulose
 Class : synthetic disacchride derivate of lactulose
 MOA : Reduce the intestinal production and absorption of ammonia

Inj.lesuride
 Class : BenzamideMOA : Blocking the D2dopaminergic receptors

T.udilivClass :
 class:Bilary agents
 MOA : Reduce the synthesis and formation of cholesterol and thus reduce the cholesterol
 Inj.ondonetron
 Class : Serotonin 5-HT3receptor antagonist
DISCHARGE SUMMARY
 Name of patient : Saroja
 Age : 15years
 Ward : General medical ward-II
 Date of admission : 20-2-24
 Date of discharge:26-2-24
 Prescription medications :
 T.Pct 40mg 1-1-1
 T udiliv 1-0-1
 Syrup.sucralfate 10ml 1-1-1
 Syrup lactulose 15ml 0-0-1