Management of Dengue Fever

In this article, we will discuss the Management of Dengue Fever. So, let’s get started.

Management

Early recognition is necessary because of the need for virus specific therapy and supportive measures the treatments include:

  • Judicious fluid therapy: All patients do not require admission. Patients with mild circulatory collapse or hypertension required fluid replacement by mouth and close monitoring of the vital signs. Patient presenting with circulatory collapse (hypovolemia, cold extremities, pallor, oligouria) and falling platelet count require hospitalization for fluid replacement. Intravenous fluids (5% dextrose in half normal saline or Ringer’s lactate) are given in the beginning. If no improvement occurs, or in severe cases, a plasma expander may be given as rapidly as possible to produce volume expansion. Fluids are to be continued till patient comes out of shock and vital parameters improve.
  • Pressor agents: Pressor agents along with fluid therapy may be used to resuscitate shock in severe cases. Blood pressure is to be maintained above 90 mmHg.
  • Oxygen therapy should be used to improve oxygenation.
  • Blood transfusion is given in the presence of massive bleeding with falling haematocrit.
  • Coagulopathy or thrombocytopenia may need cryoprecipitate and platelets transfusion. Platelet transfusion may be considered for severe thrombocytopenia (count <10,000/mcL) or when there is evidence of bleeding. IVIG Anti-Rho globulin have been found effective in thrombocytopenia.
  • Corticosteroids are not much of help.
  • Antiviral therapy has also not been found useful.
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