Day of Fever Presentation Patho- Clinical Supportive Treatment Results with
physiology presentation laboratory findings or without
complications 0-14 incubation period None Day 1 -3 Fever,headache,aches&pain Vi raemia Chills and Take baseline esp. paracetamol rigors Haematocrit;platelet count Day 4 Fever may drop suddenly, Immune Abdominal Haematocrit Encourage but still ill,lethargic reaction pain, Cold & increases from fluids. IV line for Early warning starts. clammy baseline. normal signs appear. Stage of extremities, May not see change maintainence Entering vasodilatation Erythematous in platelet count. infusion stage of flushing of hypovolemia skin, low Take baseline LFT No bleeding pulse volume, esp. Transaminase yet. Narrow pulse REVERSIBLE pressure STAGE Day 5&6 Fever may rise again. Ongoing As above, Haematocrit high. Require Bolus Patient still ill, lethargic. immune with little or Platelet counts fall infusions to Recovery This stage may last reaction. no evidence from baseline. May maintain stage. from 2-3 days. Vasodilitation microvascular be considered low. vascular Dengue with Classical Dengue bleeds on volume. Second little or no /Dengue without mucosal Transaminase levels drip line for this. warning complications surfaces increase. signs. Variations in pulse Classical and blood pressure Dengue +/- IgM and Dengue PRP positive Day 7-8 Fever falls gradually. Can be Stage of May still have Haematocrit Be careful of May see RECOVERY encouraged to drink immune abdominal stabilizes. bolus fluid Islands of reaction but pain Platelet count shows infusions. white in sea peak activity Epigastric no change . Maintain of red. dropped. tenderness. Stationary. maintainence Can go home Liver may be drip and adjust if results are palpable and accordingly stable. If drip tender is not taken care of can develop effusions Day 5&6 Ongoing May still have Haematoctit Dengue with Critical stage may last Fever may rise again. immune abdominal fluctuates with warning from 2-3 days. Patient still ill, lethargic. reaction. pain volume May require signs. Or May be restless. Abdomen Vasodilitation Epigastric replacement. macromolecular Dangers- - Dengue Fever with may appear full or early with tenderness. Platelet count can infusions/ initially Complications/Dengue distension with pain in increasing Liver may be have drastic falls plasma or fresh hypovolemic Shock Syndrome epigastrium and vasculitis palpable and blood according shock now hypochondrium tender. May Blood pressure may to rapid fall in with wide tenderness. see some fall with low volume haematocrit, spread petecheae on pulse may be rapid blood pressure mucosal skin & and tready and platelet bleeding mucosal count. .IMPENDING surface. SHOCK /or Bruises and SHOCK ecchymosis at injection sites. DSS or In recovery : Effusions. GI Bleeding or bleeding into vital organs such as heart lungs and CNS Encephalitis (rare) Complications of Transaminitis common in older age groups with sero reactive manifestations such as joint pains and SLE,RA dengue: manifestations . Dengue can reoccur as there is no cross immunity between the types.(1.II,III and IV)