Académique Documents
Professionnel Documents
Culture Documents
Presented by:
Ivan Nugraha
Supervisor:
dr. Pulung M. Silallahi, SpA
Department of Pediatrics
Bhayangkara Tk. I R. Said Sukanto Hospital
YARSI University Jakarta
2017
Dengue
Dengue Fever
is an infectious disease caused by dengue
virus with clinical manifestations of fever,
muscle pain and / or joint pain that is
accompanied by leukopenia, rash,
lymphadenopathy, and thrombocytopenia.
Dengue Hemorrhagic Fever
Plasma leakage occurs characterized by
hemoconcentration (increased
hematocrit) or accumulation of fluid in
the body cavity
Epidemiology
WHO. Handbook for Clinical Management of Dengue. World Health Organization 2012.
Demam dengue
DHF
Bleeding in the skin and organs
Petechiae, nose bleeding, bloody
stool, hematuria.
Diagnosis
Supporting
Investigation
A. Laboratory examination
Thrombocytopenia (<100,000/ul)
Hemoconcentration
Leukopenia / leukocytosis
Relative lymphocytosis with atypical
lymphocytes
Hypoproteinemia
Reduction of fibrinogen, prothrombin, factor
VIII, factor XII, and antithrombin III.
Prolonged PTT and aPTT
Diagnosis
Supporting
Investigation
CLINICAL CRITERIA
Fever
Bleeding manifestations, (1):
Test tourniquets (+)
Petechie, ekhimosis or purpura
Gastrointestinal tract mucosal bleeding,
epistaxis
Hematemesis and melena
Hepatomegaly
Failure circulation (signs of shock): cold
extremities, systolic less than 90 mmHg, moist
skin, narrowing of pulse pressure (<20 mmHg)
Diagnosis
Criteria Diagnosis
LABORATORY CRITERIA
Chikungunya
Bacterial disease
Parasitic disease
Malaria
Diff erential
Diagnosis
Management
2. Appetite improved
4. Hematocrit stable
Dengue encephalopathy
Kidney disorder
Pulmonary edema
Prognosis
If not accompanied by shock within 24-36 hours Good
> 36 hours there has been no sign of improvement, the
possibility of recovery becomes small and poor prognosis
Causes of death include:
Shock
Overhydration
Massive Bleeding
Dengue shock accompanied by manifestations of
shock
Prevention
1. VECTOR CONTROL
GOVERNMENT
SOCIETY (PHBS)
2. EPIDEMIOLOGY INVESTIGATION
Focus Foging
Abatisasi
Prevention
1) Preventive efforts, fogging mass before the
transmission of the disease in the village / sub
endemic
http://www.mims.com/philippines/drug/info/dengvaxia%20md
http://www.mims.com/philippines/drug/info/dengvaxia
References
Kliegman RM. Nelson Textbook of Pediatrics, 20th edition. Philadelphia. Elsevier: 2016.
Messina JP. Global spread of dengue virus types: mapping the 70 year history. Trends Microbiol.
2014;22(3):138146.
Karyanti MR, Uiterwaal CSP, Kusriastuti R, Hadinegoro SR, Rovers MM, Heesterbeek H, et al.
The Changing Incidence of Dengue Haemorrhagic Fever in Indonesia: a 45-year registry-based
analysis. Karyanti et al. BMC Infectious Diseases 2014, 14:412.
WHO. Global Strategy for Dengue Prevention and Control 2012-2020. World Health
Organization: 2012.
WHO. Weekly Epidemiological Record Dengue Vaccine: WHO Position Paper July 2016. No
30, 2016, 91, 349-364.
Guzman MG. Dengue. Lancet. 2015;385(9966):453465.
CDC. Dengue and Dengue Hemorrhagic Fever: Information for Health Care Practitioners. U.S.
Department of Health and Human Services Centers for Disease Control and Prevention.
WHO. Dengue Guidelines for Diagnosis, Treatment, Prevention, and Control. World Health
Organization: 2009.
CDC. Dengue and Dengue Hemorrhagic Fever: Information for Health Care Practitioners. U.S.
Department of Health and Human Services Centers for Disease Control and Prevention.
WHO. Handbook for Clinical Management of Dengue. World Health Organization 2012.
Capeding MR. Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy
children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial. Lancet.
2014;384(9951):13581365.
Villar L. Efficacy of a tetravalent dengue vaccine in children in Latin America. N Engl J Med.
2015;372(2):113123.