Question

1. On a hot summer day, a 23-year old man was brought to the ER 3 days after onset of fever, severe headache, and muscle pain. He was also experiencing nausea, vomiting, and abdominal pain. A fine, spotted rash was seen on his extremities and trunk; the patient said the rash appeared the day earlier. He recently visited North Carolina and had no prior history of illness. He had received all of his appropriate childhood illnesses.

What disease does this patient have? What is the likely etiological agent? How would you treat? (10 pts)

Answer 1

Answer- the disease is dengue hemorrhagic fever. All symptoms of fever , vomitting abdominal and muscle pain and rash is consistent with dengue fever.

The etiological agent is dengue virus of flaviviridae family , carried by the vector Aedes aegypti mosquito.

Treatment -

No specific treatment for dengue , analgesics are used to releive pain and fever symptoms, fluid replacement and blood transfusion and vasopressors inficated in hemorrhagic fever and dengue shock syndrome. Mild cases recover spontaneously on their own .

Management-

Analgesics - such as paracetamol for pain and monitor vitals.

Fluid replacement therapy- patients with circulatory collapse or hypotension , decreased platelet count require fluid replacement and hospitalisation such as I.V 5% dextrose in Ringers lactate initially , if improvement does not occur plasma expanders are administered for volume expansion . Fluids are continued until patient comes out of the shock.

Pressor agents - along with fluif therapy to resuscitate shock in severe shock cases.

Ocugen therpy - imoroves oxygenation.

Blood transfusion- massive hemorrhage cases where hematocrit falls rapidly.

Cryoprecipitate or platelet transfusion- in thrombocytopenia( decreased platelet count) causing coagulopathies .

Intravenous anti D globulin can be used , not much evidence supporting it.

If this helps please give it a positive rating thank you!