Dengue hemorrhagic fever is a severe, potentially deadly infection spread by mosquitos, mainly the species Aedes aegypti.
Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever
Causes, incidence, and risk factors
Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person is bitten by a mosquito that is infected with the virus.
There are more than 100 million new cases of dengue fever every year throughout the world. A small number of these develop into dengue hemorrhagic fever. Most infections in the United States are brought in from other countries. Risk factors for dengue hemorrhagic fever include having antibodies to dengue virus from an earlier infection and being younger than 12, female, or Caucasian.
Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever. But after several days the patient becomes irritable,
Bleeding appears as tiny spots of blood on the skin (
Shock can lead t death. If the patient survives, recovery begins after a one-day crisis period.
Early symptoms include:
- Decreased appetite
- Joint or muscle aches
- Restlessness followed by:
- Generalized rash
- Worsening of earlier symptoms
- Shock-like state
- Cold, clammy extremities
Signs and tests
- Low blood pressure
- Red eyes
- Red throat
- Swollen glands
Tests may include:
- Arterial blood gases
- Blood tests (find signs of the virus in the blood)
- Coagulation studies
- Liver enzymes
- Platelet count
- Serum studies from samples taken during acute illness and convalescence (increase in
titerto Dengue antigen)
- Tourniquet test (causes petechiae to form below the tourniquet)
X-ray of the chest(may demonstrate pleural effusion)
Because Dengue hemorrhagic fever is caused by a virus for which there is no known cure or vaccine, the only treatment is to treat the symptoms.
A transfusion of fresh blood or
plateletscan correct bleeding problems
Intravenous(IV) fluids and electrolytes are also used to correct electrolyte imbalances
- Oxygen therapy may be needed to treat abnormally low blood oxygen
Rehydration with intravenous (IV) fluids is often necessary to treat dehydration
Supportive care in an intensive care unit/environment
With early and aggressive care, most patients recover from dengue hemorrhagic fever. However, half of untreated patients who go into shock do not survive.
- Liver damage
- Residual brain damage
Calling your health care provider
See your health care provider right away if you have symptoms of dengue fever and have been in an area where dengue fever occurs, and especially if you have had dengue fever before.
There is no vaccine to prevent dengue fever. Use personal protection such as full-coverage clothing, mosquito nets, mosquito repellent containing DEET. If possible, travel during times of the day when mosquitos are not so active. Mosquito abatement (control) programs can also reduce the risk of infection.