infectious diseases
Dengue Hemorrhagic Fever Dengue Shock Syndrome
Symptoms and Signs of Dengue Hemorrhagic Fever
Dengue hemorrhagic fever often begins with abrupt fever and headache and is initially indistinguishable from classic dengue. Warning signs that predict possible progression to severe dengue include Severe abdominal pain and tenderness Persistent vomiting Hematemesis Epistaxis or bleeding from the gums Black, tarry stools (melena) Edema Lethargy, confusion, or restlessness Hepatomegaly, pleural effusion, or ascites Marked change in temperature (from fever to hypothermia) Circulatory collapse and multiorgan failure, called dengue shock syndrome, may develop rapidly 2 to 6 days after onset. Bleeding tendenciesmanifest as follows: Usually as purpura, petechiae, or ecchymoses at injection sites Sometimes as hematemesis, melena, or epistaxis Occasionally as subarachnoid hemorrhage Bronchopneumonia with or without bilateral pleural effusions is common. Myocarditis can occur. Mortality is usually<1% in experienced centers but otherwise can range to up 30%. 