Dengue hemorrhagic fever

Dengue hemorrhagic fever is a dangerous complication of dengue infection which is a viral infection transmitted by mosquitoes. Even though the disease is rare in developed countries, it remains as a leading cause of illness and death in tropical and sub-tropical countries.

The condition is characterized by fever that lasts for 2 days up to a week and accompanied by symptoms present in the milder infection or dengue fever such as eye pain, headaches, easy bleeding or bruising and musculoskeletal pain. As the fever settles, fluid starts to leak from the capillaries. The fluid can accumulate in the abdominal cavity or around the lungs. In such cases, intravenous fluids are required to support the circulatory system.

What are the indications?

The initial symptoms of dengue hemorrhagic fever include the following:

Early symptoms

  • Muscle, bone or joint pain
  • Fever
  • Cold, clammy skin
  • Eye pain
    Dengue hemorrhagic fever

    The condition is characterized by fever that lasts for 2 days up to a week and accompanied by symptoms present in the milder infection or dengue fever such as eye pain, headaches, easy bleeding or bruising and musculoskeletal pain.

  • Headache
  • Generalized feeling of being sick
  • Appetite loss
  • Nausea with or without vomiting

Late symptoms

  • Abdominal pain
  • Rash
  • Ascites of accumulation of fluid in the abdomen
  • Easy bleeding or bruising
  • Irritability and restlessness
  • Continuous episodes of vomiting
  • Red to reddish-purple spots or patches on the skin
  • Sweating
  • Shortness of breath

Risk factors

Various factors increase the risk for developing dengue hemorrhagic fever.

  • Caucasian race
  • Children below 12 years of age
  • Previous dengue infection
  • Female
  • Living or travelling to an area where dengue is endemic

Management

At the present, there are no available medications to manage dengue hemorrhagic fever. The objective of treatment is to provide comfort and support during the crisis period of the disease.

The treatment includes fluid and blood product replacement as needed as well as comfort care such as the following:

  • Bed rest
  • Hospitalization at an intensive care unit
  • Oxygen therapy
  • Intravenous fluids and electrolytes
  • Oral fluids as tolerated
  • Transfusion of blood and platelets as needed

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