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Dengue hemorrhagic fever
Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever
Dengue hemorrhagic fever is a severe, potentially deadly infection spread by some mosquitos.
Causes
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. The mosquito Aedes aegypti is the main species that spreads this disease.
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.
Symptoms
Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever. But after several days the infected person becomes irritable, restless , and sweaty. These symptoms are followed by a shock -like state.
Restless
Agitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.
Shock
Sepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.
Bleeding appears as tiny spots of blood on the skin and larger patches of blood under the skin. Minor injuries can cause bleeding.
Shock can lead to death. If the person survives, recovery begins after a 1-day crisis period.
Early symptoms include:
- Decreased appetite
- Fever
- Headache
- Joint or muscle aches
- General ill feeling
- Vomiting
Acute phase symptoms include restlessness followed by:
Acute
Acute means sudden or severe. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
- Patches of blood under the skin
- Tiny spots of blood on the skin
- Generalized rash
- Worsening early symptoms
The acute phase also includes a shock-like state with:
- Cold, clammy arms and legs
- Sweating
Exams and Tests
A physical examination may reveal:
Physical examination
During a physical examination, a health care provider studies your body to determine if you do or do not have a physical problem. A physical examinat...
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Enlarged liver
Enlarged liver
Hepatomegaly is swelling of the liver beyond its normal size. If both the liver and spleen are enlarged, it is called hepatosplenomegaly.
ImageRead Article Now Book Mark Article - Low blood pressure
- Rash
- Red eyes
- Red throat
- Swollen glands
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Weak,
rapid pulse
Rapid pulse
A bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.
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Tests may include:
- Arterial blood gases
- Blood tests (to find signs of the virus in the blood)
- Coagulation studies
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Electrolytes
Electrolytes
Electrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...
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Hematocrit
Hematocrit
Hematocrit is a blood test that measures how much of a person's blood is made up of red blood cells. This measurement depends on the number of and s...
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- Platelet count
- Serum studies from samples taken during acute illness and afterward
- Tourniquet test (causes blood patches to form below the tourniquet)
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X-ray of the chest
(may show buildup of fluid in the lungs and chest)
X-ray of the chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Treatment
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. These treatments may include:
-
A transfusion of fresh blood or
platelets
to correct bleeding problems
Platelets
A platelet count is a lab test to measure how many platelets you have in your blood. Platelets are parts of the blood that help the blood clot. The...
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Intravenous
(IV) fluids and electrolytes to correct
electrolyte imbalances
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
Read Article Now Book Mark ArticleElectrolyte imbalances
A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...
Read Article Now Book Mark Article - Oxygen therapy to treat abnormally low blood oxygen
- Rehydration with intravenous (IV) fluids to treat dehydration
- Supportive care in an intensive care unit or similar setting
Outlook (Prognosis)
With early and aggressive care, most people recover from dengue hemorrhagic fever. However, half of untreated people who go into shock do not survive.
Possible Complications
Dengue hemorrhagic fever may cause these complications:
- Brain disease
- Liver damage
- Residual brain damage
- Seizures
- Shock
When to Contact a Medical Professional
See your health care provider right away if you have symptoms of dengue fever and have been in an area where dengue fever occurs, especially if you have had dengue fever before.
Prevention
Because there is no way 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 mosquitoes are less active. Mosquito control programs can also reduce the risk of infection.
References
Thomas SJ, Endy TP, Rothman AL, Barrett AD. Flaviviruses (dengue, yellow fever, Japanese encephalitis, West Nile encephalitis, St. Louis encephalitis, tick-borne encephalitis, Kyasanur Forest disease, Alkhurma hemorrhagic fever, Zika). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 155.
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Mosquito, adult feeding on the skin - illustration
There are many different species of mosquito, which can carry some of the world's most common and significant infectious diseases, including West Nile, Malaria, yellow fever, viral encephalitis, and dengue fever. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, adult feeding on the skin
illustration
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Mosquito, adult - illustration
This illustration shows an adult southern house mosquito. This mosquito feeds on blood and is the carrier of many diseases, such as encephalitis, West Nile, dengue fever, yellow fever, and others. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, adult
illustration
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Mosquito, egg raft - illustration
Mosquitoes of the Culex species lay their eggs in the form of egg rafts that float in still or stagnant water. The mosquito lays the eggs one at a time sticking them together in the shape of a raft. An egg raft can contain from 100 - 400 eggs. The eggs go through larval and pupal stages and feed on micro-organisms before developing into flying mosquitoes. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, egg raft
illustration
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Mosquito, larvae - illustration
This picture shows mosquito larvae, an early stage of the mosquito life cycle. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, larvae
illustration
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Mosquito, pupa - illustration
These are mosquito pupa. This is another stage in the development of the mosquito. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, pupa
illustration
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Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
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Mosquito, adult feeding on the skin - illustration
There are many different species of mosquito, which can carry some of the world's most common and significant infectious diseases, including West Nile, Malaria, yellow fever, viral encephalitis, and dengue fever. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, adult feeding on the skin
illustration
-
Mosquito, adult - illustration
This illustration shows an adult southern house mosquito. This mosquito feeds on blood and is the carrier of many diseases, such as encephalitis, West Nile, dengue fever, yellow fever, and others. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, adult
illustration
-
Mosquito, egg raft - illustration
Mosquitoes of the Culex species lay their eggs in the form of egg rafts that float in still or stagnant water. The mosquito lays the eggs one at a time sticking them together in the shape of a raft. An egg raft can contain from 100 - 400 eggs. The eggs go through larval and pupal stages and feed on micro-organisms before developing into flying mosquitoes. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, egg raft
illustration
-
Mosquito, larvae - illustration
This picture shows mosquito larvae, an early stage of the mosquito life cycle. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, larvae
illustration
-
Mosquito, pupa - illustration
These are mosquito pupa. This is another stage in the development of the mosquito. (Image courtesy of the Centers for Disease Control and Prevention.)
Mosquito, pupa
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 11/14/2016
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
