Dhf is characterized by sustained high fever for 27 days. Other members of the same genus include yellow fever virus, west nile virus, zika virus, st. Infection by any one of the four serotypes of dengue virus denv remains asymptomatic in the vast majority. Dengue vaccine is used in all the endemic countries currently f. Jan 17, 2016 the supportive care in dengue includes fluid replacement and close monitoring of platelet and hct c. The common severe syndromedengue haemorrhagic feverdengue shock syndrome dhfdssis characterised by sudden vascular permeability generated by cytokines released when t cells attack dengueinfected cells.
Since the second edition of dengue haemorrhagic fever. Around the time the fever begins to subside usually 37 days after symptom onset, the patient may develop warning signs of severe disease. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Thrombocytopenia, preventitive, arbovirus, bleeding, hemorrhage introduction dengue fever df is the most common mosquitoborne human viral illness worldwide, and has rapidly spread to reach hyperendemic proportions in the urban tropics over the last quarter of a century.
Dengue fever may adversely affect cardiac function. All can cause syndromes that are selflimited or severe. High circulating levels of the dengue virus nonstructural protein ns1 early in dengue illness correlate with the development of dengue hemorrhagic fever. Dengue fever is a mosquitoborne viral illness found throughout the. Dengue is an important cause of childhood and adult morbidity in asian and latin american countries and its geographic footprint is growing. Dengue hemorrhagic fever can occur when someone is bitten by a mosquito or exposed to blood infected with the dengue virus. A viral hemorrhagic fever is a possible cause of the plague of athens during the peloponnesian war. Dhf starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Pathogenesis people bitten by aedes aegypti mosquito are diagnosed with high fever and severe joint pain that are the common symptoms of dengue fever 16. Nutritional status of children with dengue hemorrhagic fever. 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. Dv infection is mostly asymptomatic or produces a mild selflimiting acute febrile illness, dengue fever df. These highly infectious viruses lead to a potentially lethal disease syndrome characterized by fever, malaise, vomiting, mucosal and gastrointestinal gi bleeding, edema, and hypotension. It is characterized by biphasic fever, myalgia, headache, pain in various parts of the body, rash, lymphadenopathy, and leucopenia1,2.
Pathology of dengue virus infection and dengue hemorrhagic. Df is selflimited, but, it will progress to dengue hemorrhagic fever dhf or dengue shock syndrome. If left untreated, dengue fever can develop into the fatal dengue hemorrhagic fever dhf. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Secondary infection by a different dengue virus serotype has been confirmed as an important risk factor for the development of dhf. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever dhf, and eventually dengue shock syndrome dss.
Dengue hemorrhagic fever nursing care management and study guide. The four dengue viruses are transmitted in tropical countries that circle the globe. Histologic, viral, and molecular correlates of dengue fever liver histopathology and biological correlates in five cases of fatal dengue fever in vietnamese children. They are rna viruses that belong to the flavivirus genusflaviviridae family, which also includes the yellow fever virus, west nile virus, japanese encephalitis virus, zika virus, and the st louis encephalitis virus. The pathology of dengue hemorrhagic fever request pdf.
Globally, it is estimated that approximate 50 to 100 million new dengue virus infections occur annually. Clinical spectrum among symptomatic infection ranges from undifferentiated fever viral syndrome, dengue fever df, and dengue haemorrhagic fever dhf to the expanded dengue syndrome with isolated organopathy unusual manifestations. Dengue virus infection has been counted among emerging and reemerging diseases because of 1 the increasing number of patients, 2 the expansion of epidemic areas, and 3 the appearance of severe clinical manifestation of dengue hemorrhagic fever dhf dengue shock syndrome dss, which is often fatal if not properly treated. Texas has the highest number of cases of dengue fever in the united states. Pathophysiology and management of dengue hemorrhagic fever chuansumrit 2006 transfusion alternatives in transfusion medicine wiley online library. The initial, and currently only, outbreak of lujo virus in septemberoctober 2008 left 45 patients dead. The traditional classification is divided into dengue fever, dengue haemorrhagic fever, and dengue shock syndrome. Jul 11, 2018 why cant your body handle a punch to the liver. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. It is felt that competent mosquito vectors are located in twentyeight of the fifty states. Dengue infection is caused by 4 antigenically distinct dengue virus serotypes. Dengue infection is caused by any of four dengue virus serotypes. Dengue fever virus denv is an rna virus of the family flaviviridae.
In a small proportion of cases, the virus causes increased vascular permeability that leads to a bleeding diathesis or disseminated intravascular coagulation dic known as dengue hemorrhagic fever dhf. An echocardiographic study by khongphatthanayothin et al. May 03, 2019 dengue fever is a benign, acute febrile syndrome occurring in tropical regions. Dengue initially is inoculated into the skin by the aedes mosquito, where it infects skin dendritic cells. Dengue hemorrhagic fever may arise from repeated infection with different serotypes of the dengue virus. Viral hemorrhagic fevers vhfs are a diverse group of animal and human illnesses in which fever and hemorrhage are caused by a viral infection. Louis encephalitis virus, japanese encephalitis virus, tickborne encephalitis virus, kyasanur forest disease virus, and omsk hemorrhagic fever virus. Pathophysiology dengue hemorrhagic fever virus veterinary. The cause of thrombocytopenia in dengue is thought to be an immunerelated process. Dengue vaccine is given to new born babies as preventive method g. Apr 03, 2016 this video aims to describe the mode of replication of dengue virus and the pathophysiology of dengue. Guerdan, md, mph abstract in september 2009 the first documented, locally acquired cases of dengue fever in eighty years were diagnosed in individuals living in or visiting key west, florida.
Request pdf pathophysiology and management of dengue hemorrhagic fever dengue infection is caused by any of four dengue virus serotypes. Pathophysiology and pathogenesis of dengue haemorrhagic fever. Bleeding diathesis in dengue hemorrhagic fever dhf is caused by a combination of plasma leakage, vasculopathy, thrombocytopenia, platelet dysfunction, and coagulopathy. Infection may be asymptomatic or present with a broad range of clinical manifestations including a mild febrile illness to a lifethreatening shock syndrome. Who, comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever, 2011. Dengue should be considered as the possible etiology. In a small proportion of cases, the disease develops into severe dengue, also known as dengue. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a. A syndrome due to the dengue virus that tends to affect children under 10, causing abdominal pain, hemorrhage bleeding and circulatory collapse. Pathogenesis and pathophysiology of dengue hemorrhagic fever. Pathophysiology dengue hemorrhagic fever is a severe, potentially deadly infection spread by some mosquitos. 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.
As the mosquito feeds on the human host, it injects the dengue virus denv into the bloodstream. Mar 16, 2017 viral hemorrhagic fevers vhfs are a group of febrile illnesses caused by rna viruses from several viral families. This video aims to describe the mode of replication of dengue virus and the pathophysiology of dengue. It is a vasculopathy that consists in endothelial lesions which allow plasma leakage and hemorrhages. The pathology of dengue hemorrhagic fever sciencedirect. Dengue fever dengue hemorrhagic fever dengue fever dengue hemorrhagic fever bruce r. The clinical manifestations range from asymptomatic infection to undifferentiated.
Perubatan ud54 slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Dengue hemorrhagic fever and dengue shock syndrome some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and sometimes fatal form of the disease. These viruses are related to the viruses that cause the west nile infection and yellow fever. Department of health and human services centers for. All types of vhf are characterized by fever and bleeding disorders and all can progress to high fever. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Viral hemorrhagic fevers vhfs are a group of febrile illnesses caused by rna viruses from several viral families. Dengue fever is common in tropical areas, so take extra precautions if you travel somewhere with this type of climate. Impact of dengue virus infection and its control pathogens. Vhfs may be caused by five distinct families of rna viruses. Acute reversible hypokinesia and reduction in left ventricular ejection fraction was also reported by wali. Dengue fever is a mosquitoborne tropical disease caused by the dengue virus. Dengue fever is an acute infectious disease caused by four serotypes of dengue virus. Today, dengue is the most frequent arbovirus infection with more than 100 million cases annually throughout the world, including up to 0.
The first infection with dengue often causes mild to moderate disease, whereas the second infection can create a lifethreatening hemorrhagic fever. Symptoms typically begin three to fourteen days after infection. Dengue hemorrhagic fever india pdf ppt case reports. Dengue virus produces a mild acute febrile illness, dengue fever df and a severe illness, dengue hemorrhagic fever dhf. Plasma leakage and intrinsic coagulopathy are the pathological hall marks in dengue haemorrhagic fever dhf. Burke, evidence that maternal dengue antibodies are important in the development of dengue hemorrhagic fever in infants, american journal of tropical medicine and hygiene, vol. Pathogenesis of dengue haemorrhagic fever and its impact. Some patients with dengue fever go on to develop dengue hemorrhagic fever dhf, a severe and. The who estimates that 50100 million cases of dengue infection occur annually, with approximately 500,000 of those cases resulting in dengue hemorrhagic fever dhf, with an estimated 22,000 deaths per year, mostly in children. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of.
A viral hemorrhagic fever is an alternate theory of the cause of the black death and the plague of justinian. Aetiology,pathophysiology and diagnosis of dengue infection. Dengue virus dv is transmitted through mosquito bite and is prevalent in over 100 tropical and subtropical countries with about 2 000 000 000 people at risk. Summary dengue infection is caused by any of four dengue virus serotypes. Pathophysiology plasma leakage denvinfected cells release inflammatory mediators, immune complexes are formed, and the complement cascade is activated resulting in increased vascular permeability and hemorrhagic manifestations that characterize severe dengue. Todays topics arboviruses general concept dengue fever and dengue hemorrhagic fever mcqs and case studies 3. The characteristic feature of dhf is increased capillary permeability leading to extensive plasma leakage in serous cavities resulting in shock. 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. Dec 07, 2018 dengue is also known as breakbone fever, hemorrhagic fever, dandy fever, infectious thrombocytopenic purpura. Sep 17, 2010 aetiology, pathophysiology and diagnosis of dengue infection dr lee oi wah peg. The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagi. The pathophysiology of the severe forms of dengue may be related to sequential infection with different serotypes, variations in virus virulence, interaction of the virus with environmental and host factors or a combination of these factors.
A prospective nested casecontrol study of dengue in infants. Alternate hypothesis on the pathogenesis of dengue. Symptoms of dengue hemorrhagic fever are fever that lasts from 2 to 7 days, vomiting blood, drowsiness, bleeding from nose or gums. Although dengue is a very old disease but recently an alarming increase has been seen in the geographic range, along with the severity of. Dengue virus infection has been counted among emerging and reemerging diseases because of 1 the increasing number of patients, 2 the expansion of epidemic areas, and 3 the appearance of severe clinical manifestation of dengue hemorrhagic fever dhfdengue shock syndrome dss, which is often fatal if not properly treated. Pathophysiology and management of dengue hemorrhagic fever. Coagulopathy in dengue infection and the role of interleukin6. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever vii dengue fever is the fastest emerging arboviral infection spread by aedes mosquitoes with major public health consequences in over 100 tropical and subtropical countries in southeast asia, the western pacific and south and central america. Defined by the presence of fever and 2 or more of the following but not meeting the case definition of dengue haemorrhagic fever.
These highly infectious viruses lead to a potentially lethal disease syndrome characterized by fever, malaise, vomiting, mucosal and gastrointestinal gi. Summary much remains to be learned about the pathogenesis of the different manifestations of dengue virus denv infections in humans. Pathophysiology dengue hemorrhagic fever free download as word doc. Viral hemorrhagic fever dengue fever presented by jega subramaniam, student guided by ap. 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. The clinical manifestations range from asymptomatic infection to undifferentiated fever, dengue fever and dengue hemorrhagic fever dhf. View enhanced pdf access article on wiley online library html view download pdf for offline viewing.
Jan 09, 2008 dengue fever is an acute infectious disease caused by four serotypes of dengue virus. Dengue hemorrhagic fever is a fatal manifestation of dengue virus that manifest with bleeding diathesis and hypovolemic shock. If left untreated, dengue fever can develop into the fatal dengue. As both cell tropism and tissue tropism of denv are considered major determinants in the pathogenesis of dengue, there is a critical need for adequate tropism assays, animal models, and human autopsy data. The clinical manifestations of dengue are the expression of a constellation of host and viral factors, some acquired, others intrinsic to the individual. The most common hemorrhagic manifestations are mild and include a positive tourniquet test, skin hemorrhages petechiae, hematomas, epistaxis nose bleed, gingival bleeding gum bleed, and microscopic hematuria. The clinical manifestations range from asymptomatic infection to.
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