Dengue fever is a viral illness transmitted primarily by mosquitoes, particularly the Aedes species. It can cause symptoms like high fever, severe headache, joint and muscle pain, and rash. In some cases, it can lead to a more severe form called dengue hemorrhagic fever, which can be life-threatening. Preventing mosquito bites and controlling mosquito populations are key strategies to prevent dengue transmission.

cause of Dengue fever

Dengue is primarily caused by the dengue virus, which is transmitted to humans through the bites of infected Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus. These mosquitoes become infected when they bite a person already infected with the virus. The virus cannot be spread directly from person to person. Factors such as stagnant water, urbanization, and travel to dengue-endemic areas can contribute to the spread of the disease by creating favorable conditions for mosquito breeding and transmission.

types of Dengue fever

There are four distinct serotypes of the dengue virus: DEN-1, DEN-2, DEN-3, and DEN-4. Each serotype can cause the same range of symptoms, from mild dengue fever to severe dengue hemorrhagic fever. Having immunity to one serotype does not provide immunity to the others, and subsequent infections with different serotypes can increase the risk of severe dengue.

pathophysiology

The pathophysiology of dengue involves several key processes:

  1. Virus Replication and Immune Response: After a mosquito bite, the dengue virus enters the bloodstream and infects immune cells. The immune system responds by producing antibodies to fight the virus. However, in some cases, this immune response can lead to increased viral replication and inflammation.
  2. Vascular Leakage: One of the hallmark features of severe dengue is vascular leakage. The virus affects the endothelial cells lining blood vessels, causing them to become more permeable. This can result in plasma leakage from blood vessels into surrounding tissues, leading to fluid accumulation and potentially life-threatening complications.
  3. Cytokine Storm: In severe cases, an excessive immune response can occur, known as a cytokine storm. This involves the release of a large amount of immune signaling molecules (cytokines) into the bloodstream, contributing to inflammation, tissue damage, and vascular leakage.
  4. Coagulation Abnormalities: Dengue infection can disrupt the normal balance of blood clotting, leading to coagulation abnormalities. This can contribute to bleeding tendencies, such as nosebleeds, gum bleeding, and, in severe cases, internal bleeding.
  5. Organ Involvement: Severe dengue can affect various organs, including the liver, heart, and nervous system. Liver inflammation and dysfunction can lead to elevated liver enzymes, while heart involvement can cause arrhythmias and other cardiac issues.
  6. Fluid Imbalance and Shock: The combination of vascular leakage, fluid accumulation, and changes in blood composition can lead to a state of shock known as dengue shock syndrome. This is characterized by a rapid drop in blood pressure and reduced blood circulation, which can be life-threatening if not treated promptly.

It’s important to note that the severity of dengue symptoms and complications can vary widely from person to person, and not all individuals infected with the virus will develop severe disease. Early recognition, supportive care, and proper medical management are crucial in preventing and treating severe dengue cases.

clinical features

The clinical features of dengue can vary based on the severity of the infection. Common symptoms of dengue fever include:

  1. High Fever: Sudden onset of a high fever, often reaching up to 104°F (40°C).
  2. Severe Headache: Intense and persistent headache, often located behind the eyes.
  3. Joint and Muscle Pain: Severe joint and muscle pain, often described as aching or feeling like deep bone pain.
  4. Rash: A rash that usually appears a few days after the fever starts. It can be a flat, red rash or sometimes a raised rash.
  5. Pain Behind the Eyes: Pain and discomfort, particularly when moving the eyes.
  6. Fatigue: Profound fatigue and weakness.
  7. Nausea and Vomiting: Feeling nauseated and vomiting.
  8. Mild Bleeding: Minor bleeding manifestations, such as nosebleeds or gum bleeding.

In severe cases, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) can develop:

  1. Severe Bleeding: Hemorrhagic manifestations, such as more significant bleeding from the gums or nose, as well as internal bleeding.
  2. Vascular Leakage: Increased permeability of blood vessels leading to fluid accumulation in body tissues, resulting in swelling and potential shock.
  3. Organ Involvement: Liver enlargement and damage, as well as other organ dysfunction.
  4. Shock: Rapid drop in blood pressure, leading to shock and potentially life-threatening complications.

Complications

Complications of dengue can vary in severity and may include:

  1. Dengue Hemorrhagic Fever (DHF): DHF is a severe form of dengue characterized by increased vascular permeability, which can lead to plasma leakage, internal bleeding, and shock. It may result in organ failure and can be life-threatening if not promptly treated.
  2. Dengue Shock Syndrome (DSS): DSS is a severe manifestation of dengue characterized by profound shock due to fluid loss from blood vessels. It can lead to organ failure and is considered a medical emergency.
  3. Organ Involvement: Dengue can affect various organs, including the liver, heart, and nervous system, leading to complications such as liver enlargement, abnormal heart rhythms, and neurological issues.
  4. Severe Bleeding: In some cases, dengue can lead to severe bleeding, including gastrointestinal bleeding, nosebleeds, and gum bleeding.
  5. Multi-organ Failure: Severe dengue can result in multi-organ failure, where multiple organs in the body cease to function properly.
  6. Hypovolemic Shock: This occurs when the body loses too much blood or fluid, leading to a dangerous drop in blood pressure and inadequate blood circulation.
  7. Death: While most dengue cases are mild and can be managed with appropriate medical care, severe dengue can be fatal if not treated promptly and effectively.

It’s important to note that not everyone who contracts dengue will experience complications, and the majority of cases are mild. However, being aware of the potential complications and seeking medical attention if you suspect dengue is crucial for early diagnosis and appropriate management.

Mechanism of bleeding in dengue

In dengue, bleeding can occur due to a decrease in platelet count and abnormalities in blood clotting factors. The virus affects the blood vessels, causing them to become more permeable, leading to leakage of blood components. Additionally, the immune response triggered by the virus can contribute to damage of blood vessels and platelets. These factors combined can lead to bleeding manifestations in dengue patients. If you suspect dengue, it’s important to seek medical attention promptly.

Lab diagnosis

The laboratory diagnosis of dengue typically involves tests such as:

  1. Polymerase Chain Reaction (PCR): Detects viral RNA in blood.
  2. Enzyme-Linked Immunosorbent Assay (ELISA): Detects antibodies or antigens in blood.
  3. NS1 Antigen Test: Detects dengue virus protein in blood.
  4. Hematocrit (HCT) and Platelet Count: Monitoring changes in blood components.
  5. Virus Isolation: Culturing the virus from blood or other body fluids.

Lab investigation

Laboratory investigations for dengue complications may include:

  1. Complete Blood Count (CBC): To monitor platelet and white blood cell levels.
  2. Hematocrit (HCT): Monitoring for hemoconcentration.
  3. Liver Function Tests (LFTs): Assessing liver damage.
  4. Kidney Function Tests (KFTs): Monitoring renal function.
  5. Activated Partial Thromboplastin Time (aPTT) and Prothrombin Time (PT): Assessing clotting function.
  6. Serum Electrolytes: Checking for imbalances due to fluid loss.
  7. Chest X-ray: If respiratory symptoms develop.

These tests help monitor and manage potential complications like severe bleeding, organ dysfunction, and shock associated with dengue. It’s important to consult a healthcare professional for proper evaluation and guidance.

management

The management of dengue involves supportive care to alleviate symptoms and prevent complications. Here are key aspects of dengue management:

  1. Fluid Replacement: Adequate hydration is crucial to prevent dehydration and maintain blood pressure. Oral rehydration is usually the first approach, but in severe cases, intravenous fluids may be required to manage fluid loss.
  2. Pain and Fever Relief: Over-the-counter pain relievers such as acetaminophen (paracetamol) are often recommended to manage fever and pain. Avoid using non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, as they can increase the risk of bleeding.
  3. Monitoring: Regular monitoring of vital signs (temperature, blood pressure, heart rate) and fluid balance is important to track the progression of the disease and ensure timely intervention if complications arise.
  4. Rest: Adequate rest is essential to help the body recover and conserve energy.
  5. Avoiding Aspirin and NSAIDs: Aspirin and NSAIDs should be avoided, as they can increase the risk of bleeding and other complications.
  6. Hospitalization for Severe Cases: Patients with severe dengue, such as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), may require hospitalization for close monitoring and management of complications.
  7. Platelet Transfusions: Platelet transfusions may be considered in severe cases with dangerously low platelet counts, but this is typically done in specific situations and under medical supervision.
  8. Treatment of Complications: Complications such as bleeding, shock, and organ dysfunction should be promptly addressed with appropriate medical interventions.
  9. Preventive Measures: While there is no specific antiviral treatment for dengue, prevention of mosquito bites and vector control (eliminating mosquito breeding sites) are important to reduce the risk of infection.
  10. Vaccination: In some regions, dengue vaccines have been developed and are used to prevent dengue infection. Consult a healthcare professional to determine if vaccination is recommended in your area.

It’s important to seek medical care if you suspect you have dengue, especially if you experience severe symptoms or complications. Early diagnosis and proper medical management significantly contribute to a better outcome for individuals with dengue.

Homoeopathy

In Homeopathy, the treatment procedure for epidemic diseases follows a similar approach to individualized treatment, but with a focus on the broader context of the epidemic. Here’s how homeopathy is often used in epidemic situations:

  1. Understanding the Epidemic: Homeopaths gather information about the epidemic, including the symptoms, patterns of illness, and affected population. This understanding helps in selecting appropriate remedies.
  2. Genus Epidemicus: Homeopaths aim to identify a specific homeopathic remedy that seems to match the collective symptoms and characteristics of the epidemic. This remedy is known as the “genus epidemicus.”
  3. Preventive Measures: Some homeopaths believe that homeopathic remedies can be used preventively to reduce the risk of contracting the epidemic disease. These remedies are chosen based on the prevailing symptoms and characteristics of the epidemic.
  4. Individualized Treatment: Despite the focus on the epidemic, homeopathy continues to emphasize individualized treatment. Homeopaths consider the person’s unique symptoms and constitution, even within the context of the epidemic.
  5. Dosage and Administration: Homeopathic remedies are typically administered in highly diluted and potentized forms. The dosages and frequency of administration may vary based on the severity of symptoms and the homeopath’s assessment.
  6. Monitoring and Adjustments: Regular follow-up appointments allow homeopaths to monitor the person’s response to the remedy and make adjustments as needed. If symptoms change or new symptoms emerge, the remedy may be modified.

Rubrics

Fever, heat; dengue fever: ACON(3) apis aran ars arum-t bapt bell BRY(3) canth chin coloc EUP-PER(4) ferr GELS(3) ham ip merc nux-v podo RHUS-T(3) rhus-v sanic sec sul-ac.

First stage: acon ars bry ip rhus-t.

Hemorrhagic: ars chin ferr ham sec sul-ac.

Blood; hemorrhage; fever, during: acet-ac(2) acon alum ALUMN(3) ARG-N(3) ARN(4) ARS(3) BAPT(4) bell BRY(3) cact CARB-V(4) chin CHIN-S(3) chlol CROT-C(3) CROT-H(4) cupr ELAPS(3) erig ferr ferr-m FERR-P(3) gels HAM(3) hoch hydrin-s ip KALI-C(3) kali-p kreos LACH(4) meli(2) meli-a MILL(3) MUR-AC(3) NIT-AC(3) nux-m PH-AC(3) PHOS(4) puls pyrog RHUS-T(3) sec sica-a sica-t SUL-AC(3) TER(3) trach-d.

If your patient previously suffered by inherited bleeding disorder in which the blood does not clot properly:

Blood; coagulation; difficult, absent, hemophilia: acan-p ADREN(3) agki-p(2) ail alum alumn am-c ant-t anthr(2) APIS(3) aran arg-n ARN(4) ARS(3) ars-h ASC-AC(3) bell biti-a BORR-B(3) both-a BOTH-L(4) BOV(3) bry CACT(3) caesal-s calc calc-l calc-m calc-p CALEN(3) camph cann-i canth carb-an CARB-V(3) cench cer CHIN(3) chin-s chlol chlor chloram CINNAM(3) conv cortico CROC(3) CROT-C(4) CROT-H(3) dig DOR(3) dulc dys-co ELAPS(3) erech ergot ERIG(3) FERR(4) ferr-m(2) FERR-P(3) fic gall-ac gels GER(3) HAM(3) HIR(4) hydr HYDRIN-M(3) IP(3) kali-c KALI-P(3) KREOS(4) lac-c lac-m LACH(4) lant LAT-M(4) led lipp lycpr lycps M-ART(3) m-aust mag mag-m mati(2) med meli merc merc-cy mill mur-ac naja nat-m nat-n NAT-S(3) NAT-SIL(3) NIT-AC(4) op parth ph-ac PHOS(4) puls rad-br rhus-t SABIN(3) sanguis SEC(4) sil staph(2) stram stront-c SUL-AC(3) sulph TER(3) thlaspi til toxop-p TRIL(3) ulm-c ust(2) verat vip VISC(3) x-ray XAN(3) ZINC(3).

If your patient take ASPIRIN for any medical condition: (care must be taken in discontinuing such medicine and treating with another medicine otherwise the patient may suffer.)

Generalities; intoxication, after; aspirin: ARN(3) CARB-V(3) kali-c LACH(3) mag-p nux-v.

Rubrics table

RubricACON apis aran ars arum-t bapt bell BRY canth chin colocEUP-PER ferrGELSham ip merc nux-v podo RHUS-Trhus-v sanic sec sul-ac.
Fever, heat; dengue fever++++++++++++++++++++++++++++++++++
Fever, heat; dengue fever; first stage++
+
++
Fever, heat; dengue fever; hemorrhagic++++++
Blood; hemorrhage; fever, during++++++++++++++++++++++++++++
COMPLETE DYNAMICS 23.8

for ask a question

Last update: 10/08/23

Leave a Reply

Your email address will not be published. Required fields are marked *