Dengue Hemorrhagic Fever (DHF)

A. Definition
Dengue hemorrhagic fever (DHF): A syndrome due to the dengue virus that tends to
affect children under 10, causing abdominal pain, hemorrhage (bleeding) and
circulatory collapse (shock )
B. Causes of Dengue Hemorrhagic Fever
Dengue hemorrhagic fever can occur when someone is bitten by a mosquito or
exposed to blood infected with the dengue virus. Infected mosquitoes are the most
common causes.
C. Is at High Risk for Dengue Hemorrhagic Fever
1. Living in or traveling to Southeast Asia, South and Central America, sub-Saharan
Africa, and parts of the Caribbean can increase your risk of contracting the
dengue virus.
2. infants and small children
3. pregnant women (the virus may be passed from mother to fetus)
4. older adults
5. those with compromised immune systems

D. Symptoms of Dengue Hemorrhagic Fever

DHF starts abruptly with high continuous fever and headache plus respiratory and
intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain.
Shock occurs after 2 to 6 days with sudden collapse, cool clammy extremities, weak
thready pulse, and blueness around the mouth (circumoral cyanosis). There is
bleeding with easy bruising, blood spots in the skin (petechiae), spitting up blood
(hematemesis), blood in the stool (melena), bleeding
gums and nosebleeds (epistaxis). Pneumonia and heart inflammation (myocarditis)
may be present.

E. Treatment for Dengue Hemorrhagic Fever

The goal of treatment is to manage symptoms and keep the infection from becoming
more severe. Severe cases may need emergency treatments such as:
1. hydration with intravenous (IV) fluids
2. over-the-counter or prescription drugs to manage pain
3. electrolyte therapy
4. blood transfusions
5. careful monitoring of blood pressure
6. oxygen therapy
7. skilled nursing observation
F. Complications from Dengue Hemorrhagic Fever
Complications from severe or acute dengue hemorrhagic fever may
include:seizures
1. brain damage
2. blood clots
3. damage to the liver and lungs
4. heart damage
5. shock
6. death

G. Schematic of DHF Pathogenesis, Thrombocytopenia and Plasma Leakage / Shock

Pathogenesis

Schematic of DHF Pathogenesis

 PATOGENESIS PLASMA LEAKAGE

PATOGENESIS TROMBOSITOPENIA