Adcon Dengue
Adcon Dengue
HOSPITAL
January 6-10, 2022 ADMISSION
IDENTIFYING DATA:
◦ Name: R. Z
◦ Age: 3
◦ Sex: Male
◦ Birthdate: 11/29/2018
◦ Nationality: Filipino
◦ Mother: Housewife
◦ Informant: Mother
◦ Reliability: 98%
CHIEF COMPLAINT:
FEVER x 4 DAYS
HISTORY OF PRESENT ILLNESS
◦ 4 days PTA patient was noted to have on and off fever with temperature reaching 39.4˚ and subsides in
the morning.
◦ Few hours PTA patient was brought to a pediatrician and was advised for labs, results revealed low
platelet count and positive for dengue antigen test (NS1) and was advised for admission at hospital of
choice.
PAST MEDICAL HISTORY
◦ (-) Allergy
◦ Baby was noted to have good cry and good motor activity
◦ Started introducing soft baby food after 5th month of exclusive breastfeeding
◦ Patient knows how to ride his tricycle and can climb stairs on his own
◦ Patient can button and unbutton partially his clothes and undress himself on his own
◦ Patient is also very talkative and likes to converse with mother about the shows he watches or things he observes outside
IMMUNIZATION HISTORY
BCG BCG
BCG BCG
(DtwP DTwP*/DTaP
-Hib-
HepB)
and
other
DTaPc
ombin Hib*
ations
IPV/ OPV*/IPV
OPV
PCV PCV*
Vaccination schedule
Vaccine Weeks
0 2 4 6 8 9 10 12 14 16 18 20 22
RV RV
Vaccine Months
6 8 10 12 14 16 18 20
RV RV
Measles Measles
JEV JEV
MMR MMR
Varicella VARICELLA
Skin (-) lesions or rash, (-) pruritus or skin diseases, (-) drying of skin
Heent (-) headache (-) eye pain (-) ear discharge (-) colds (-) nosebleeds (-) bleeding gums
Chest and Lungs Symmetric chest expansion, (-) Retraction, clear breath sounds upon auscultation
Neurological examination Patiebt was awake and alert. No signs or neurological deficit noted
Differential Diagnosis
Differentials RULE-IN RULE OUT
Dengue • Fever • Cannot be ruled out
• Body malaise
• Headache
• Joint pain
• Muscle pain
• Nausea and Vomiting
• Positive Antigen Test
◦ DENGUE
DISCUSSION
◦ Dengue is a mosquito-borne viral disease that has rapidly spread to all regions of WHO in recent years. Dengue virus is transmitted by
female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. These mosquitoes are also vectors of
chikungunya, yellow fever and Zika viruses. Dengue is widespread throughout the tropics, with local variations in risk influenced
by climate parameters as well as social and environmental factors.
◦ It causes a wide spectrum of disease. This can range from subclinical disease (people may not know they are even infected) to severe
flu-like symptoms in those infected. Although less common, some people develop severe dengue, which can be any number of
complications associated with severe bleeding, organ impairment and/or plasma leakage. Severe dengue has a higher risk of death
when not managed appropriately.
◦ Dengue is caused by a virus of the Flaviviridae family and there are four distinct, but closely related, serotypes of the virus that cause
dengue (DENV-1, DENV-2, DENV-3 and DENV-4). Recovery from infection is believed to provide lifelong immunity against that
serotype.
PATHOGENESIS
CLINICAL SYNDROMES
MANAGEMENT
◦ January 7, 2022
Patient was admitted under the service of Dr. Ludovice
Secured consent for admission and management
IVF: PNSS 1l x 40cc/h
Diet: for Age, avoid dark colored foods
Dx:
COVID RAT, CBC tom 6am
Medications:
Paracetamol 120mg TIV Q4 PRN for temp >37.8
AP informed of admission
COURSE IN
Relay lab results to AP once available
VS Q4 then record
THE WARD
WOF: bleeding
Refer accordingly
o January 8, 2022
IVF to follow: PNSS 1L at 4gtts/min
Repeat CBC platelet in Am
o January 9, 2022
IVF to continue then discontinue
May go home anytime