Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia


 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

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.

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:

  • 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:

  • Enlarged liver
  • Low blood pressure
  • Rash
  • Red eyes
  • Red throat
  • Swollen glands
  • Weak, rapid pulse

Tests may include:

  • Arterial blood gases
  • Blood tests (to find signs of the virus in the blood)
  • Coagulation studies
  • Electrolytes
  • Hematocrit
  • Liver enzymes
  • Platelet count
  • Serum studies from samples taken during acute illness and afterward
  • Tourniquet test (causes blood patches to form below the tourniquet)
  • X-ray of the chest (may show buildup of fluid in the lungs and chest)

 

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
  • Intravenous (IV) fluids and electrolytes to correct electrolyte imbalances
  • 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.

 
  • Mosquito, adult feeding on the skin

    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

    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

    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

    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

    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

    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

    • Mosquito, adult feeding on the skin

      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

      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

      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

      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

      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

      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

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Dengue hemorrhagic fever

           

             

            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.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
            adam.com

             
             
             

             

             

            A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



            Content is best viewed in IE9 or above, Firefox and Google Chrome browser.