Arboviral illness with febrile, critical and recovery phases; plasma leakage in the critical phase drives shock.
Clinical features
- • High fever, retro-orbital pain, myalgia
- • Rash, flushing
- • Warning signs: abdominal pain, persistent vomiting, mucosal bleed, lethargy, hepatomegaly, rising haematocrit with falling platelets
Investigations
- • NS1 antigen (days 1–5), IgM/IgG (after day 5)
- • Serial FBC — haematocrit and platelets 12-hourly
- • LFTs, ultrasound for ascites/pleural effusion
Management
- • Group A: oral fluids, paracetamol, daily review
- • Group B/C: isotonic crystalloid per WHO chart, titrate to urine output 0.5 mL/kg/h
- • Avoid NSAIDs, aspirin and IM injections
- • Platelet transfusion only for significant bleeding, not for count alone
Clinical pearls
- • Critical phase begins as fever settles (day 3–7) — that is when patients deteriorate
- • Rising haematocrit with falling platelets signals plasma leakage
Related in WardRound
Educational — verify locally.
