{"id":10464,"date":"2025-08-13T10:42:15","date_gmt":"2025-08-13T10:42:15","guid":{"rendered":"https:\/\/www.kauveryhospital.com\/ima-journal\/?p=10464"},"modified":"2025-08-14T16:28:19","modified_gmt":"2025-08-14T16:28:19","slug":"dengue-hemorrhagic-fever-a-case-report-and-management-approach","status":"publish","type":"post","link":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-august-2025\/dengue-hemorrhagic-fever-a-case-report-and-management-approach\/","title":{"rendered":"DENGUE HEMORRHAGIC FEVER \u2013 A CASE REPORT AND MANAGEMENT APPROACH"},"content":{"rendered":"

[vc_section][vc_row][vc_column][vc_column_text]<\/p>\n

INTRODUCTION<\/h2>\n

Dengue Hemorrhagic Fever (DHF) is a severe and potentially life-threatening form of dengue fever, characterized by high fever, bleeding, and low platelet count. It can lead to organ failure, and death if not treated promptly.<\/p>\n

CASE PRESENTATION<\/h2>\n

HISTORY AND CLINICAL EXAMINATION:<\/h2>\n

A 20 Year lady presented to the ER with history of high-grade fever with chills and rigors on and off past 4 days.<\/p>\n

She had recurrent seizures the previous night of admission, and was taken to a nearby hospital, in view of low GCS, patient was intubated. Her BP was not recordable she received IV Fluids and was started on Noradrenaline infusion. Was also noted to have profuse bleeding following Ryles tube. Patient was referred here for further management.<\/p>\n

PRIMARY SURVEY<\/h2>\n

AIRWAY <\/strong> \u2013 Intubated(outside). Had bloody secretions.<\/p>\n

BREATHING<\/strong> – RR :18\/M SPO2 98% on mechanical ventilation TV 480ml
\nPEEP 6 ON with FiO2 100%
\nB\/L crepitation with basal decreased AE<\/p>\n

CIRCUATION:<\/strong> – PR 166\/m BP \u00a0100\/60 mmhg with
\nINJ NORADRENALINE 10ML\/HR
\nB\/L peipheral pulse feeble with cold peripheries<\/p>\n

DISABILITY: <\/strong>GCS E1 VT M1
\nB\/L PERTL {2mm}
\nCBG : 104 mg\/l<\/p>\n

EXPOSURE:<\/strong> Febrile, 16 Fr Ryles tube in situ
\n14 Fr Foleys catheter in situ ,high coloured urine noted.
\nTongue laceration 3*1 cm no active bleed<\/p>\n

She was not known to have any drug allergies , no significant past medical or surgical history, and not on any regular medication.<\/p>\n

Outside lab values of Dengue NS1 positive, Initial Hb-12.5,TC -2980, Platelet count -11,000<\/p>\n

INVESTIGATION:<\/h2>\n

POCUS<\/strong> – B\/L B lines with mild Pleural effusion IVC >50%collapsible with free fluid in the abdomen<\/p>\n

ECG<\/strong>: Sinus tachycardia, Normal Axis , Global ST depression<\/p>\n

ABG<\/strong> with 100%Fio2: PH-7.08, PO2-68mmhg, PCO2-48mhg, HB-10.6<\/u>,
\nNa-136, K-3.0, CL-110, HCT-29, LAC-6.3, HCO3-12.9, CREATININE-1.4,<\/p>\n

PT-40.9, INR-3.6, TROPONIN-13.86<\/u><\/p>\n

ECHO<\/strong>-Global hypokinesia of left ventricle with regional variation Severe lv dysfunction, No PAH<\/p>\n

USG ABDOMEN<\/strong>-Gall bladder wall edema, adjacent bowel wall edema , free fluid in the abdomen.<\/p>\n

CT BRAIN<\/strong> \u2013 Normal<\/p>\n

DIAGNOSIS<\/strong>: Based on the Clinical findings, investigations, diagnosis of Dengue Hemorrhagic Fever \u00a0with myocarditis<\/u> was made.<\/p>\n

TREATMENT AND OUTCOME:<\/h3>\n