1.Dengue: an overview
Sekaran SD ; Rathakrishnan A ; Yeo ASL
Journal of University of Malaya Medical Centre 2014;17(2):23-32
Dengue is one of the highest occurring vector-borne diseases. It is caused by dengue viruses 1- 4. Currently,
the disease is classified into dengue with or without warning signs and severe dengue based on WHO 2009
dengue classification. As of today, neither specific drugs nor commercial vaccine exist for dengue. The best
treatment yet would be support, management and proper medical care. With no pathognomonic features
that could differentiate it from other febrile illnesses, clinical diagnosis alone is insufficient. Yet, despite the
current advances and existence of various laboratory diagnostic methods of dengue, a consensus singular
method has not been established. There are several hypotheses or theories regarding the vaguely understood
immunopathogenesis of dengue. Amongst these are the viral factors, host-immune factors and host-genetic
factors. In addition to these, the occurrence of asymptomatic dengue has further complicated the disease.
However, these individuals provide opportunities in the search for protective factors against dengue.
Dengue
2.Upper gastrointestinal haemorrhage in severe dengue: To scope or not to scope?
Chen Hong Lim ; Benjamin Han Sim Ng ; Foong Kee Kan
The Medical Journal of Malaysia 2017;72(1):55-57
Upper gastrointestinal haemorrhage (UGIH) in severe
dengue represents a clinical dilemma in term of
management. The recommended treatment in dengue with
UGIH involves blood product transfusion support and
proton pump inhibitor (PPI) infusion. Despite being the
mainstay of treatment in non-dengue UGIH, the role of
endoscopic haemostatic intervention in severe dengue
remains controversial. In the present report, we present a
case of severe dengue complicated with upper
gastrointestinal haemorrhage successfully underwent early
therapeutic endoscopic intervention in a district hospital.
Dengue
3.Bilateral thalamic internal medullary lamina involvement in a case of dengue encephalitis
Sherrini Bazir Ahmad ; Chin Sum Cheong ; Shen-Yang Lim ; Kartini Rahmat ; Faizatul Izza Rozalli ; Shamala Devi Sekaran ; Helmi Sulaiman, Sasheela Ponnampalavanar ; Kheng Seang Lim ; Chong Tin Tan
Neurology Asia 2016;21(4):375-379
There are 50-100 million dengue infections each year, but dengue encephalitis is relatively
uncommon. The aetiology of neuronal injury is proposed to be due to direct viral neurotropism or
host immune response-mediated inflammation causing neuronal damage. We report a case of severe
dengue encephalitis, presenting during the acute viraemic phase of the disease. This was associated
with inflammation and haemorrhage of the internal medullary lamina of both thalami which, to our
knowledge, has not yet been reported in other infections of the central nervous system.
Dengue
4.Early central nervous system involvement in a young patient with dengue encephalitis
Alice Verghese ; Brian Cheong Mun Keong
The Medical Journal of Malaysia 2016;71(1):41-42
A previously well 13-year-old boy presented with a short
history of fever and altered mental status. His mother was
admitted for dengue fever and there had been a recent
dengue outbreak in their neighbourhood. He was diagnosed
with dengue encephalitis as both his dengue non-structural
protein 1 (NS-1) antigen and cerebrospinal fluid (CSF)
dengue polymerase chain reaction (PCR) were positive. He
did not have haemoconcentration, thrombocytopenia or any
warning signs associated with severe dengue. He recovered
fully with supportive treatment. This case highlights the
importance of considering the diagnosis of dengue
encephalitis in patients from dengue endemic areas
presenting with an acute febrile illness and neurological
symptoms.
Dengue
5.Appendicular mass complicating acute appendicitis in a patient with dengue fever
Low Yen Nee ; Brian Cheong Mun Keong
The Medical Journal of Malaysia 2016;71(2):83-84
Abdominal pain with dengue fever can be a diagnostic
challenge. Typically, pain is localised to the epigastric region
or associated with hepatomegaly. Patients can also present
with acute abdomen. We report a case of a girl with dengue
fever and right iliac fossa pain. The diagnosis of acute
appendicitis was made only after four days of admission. An
appendicular mass and a perforated appendix was noted
during appendectomy. The patient recovered subsequently.
Features suggestive of acute appendicitis are persistent
right iliac fossa pain, localised peritonism, persistent fever
and leucocytosis. Repeated clinical assessment is important
to avoid missing a concurrent diagnosis like acute
appendicitis.
Dengue
6.A comparative study of acetated isotonic electrolyte solution, normal saline solution, and lactated ringer’s solution in the initial fluid resuscitation of children 1 month to 18 years old with severe dengue at the Philippine Children’s Medical Center.
Allen Kilby M. Palon ; Mary Joy S. Torres ; Ervina J. Astih ; Mellinor A. Aspuria-Ang
The Philippine Children’s Medical Center Journal 2018;14(1):43-60
BACKGROUND:
At PCMC, acetated isotonic electrolyte solution is used in the initial resuscitation in
severe dengue patients. However, no local study has comparedacetated isotonic electrolyte solution
against normal saline and lactated Ringer’s solutions.
OBJECTIVE:
This study aims to determine the comparative recovery time to achieve initial and
sustained cardiovascular stability in severe dengue patients using acetated isotonic electrolyte solution,
normal saline solution, and lactated Ringer’s solution.
METHODOLOGY:
This is a retrospective cohort study involving 166 severe dengue patients 1 month
to 18 years old admitted at the PICU from 2014 to 2016. They were divided into 3 groups based on the
initial fluid used: 58 in the AIES group, 58 in the NSS group, and 50 in the LRS group.
RESULTS:
AIES group had the shortest time to achieve initial and sustained stability among patients
without re-shock. Also, AIES group needed less fluid to establish stability and had less re-shock, less use
of colloid and inotropes, less blood transfusion,and less need for mechanical ventilation and dialysis. NSS
had the most fluid shift to AIES and/or colloid while LRS had the most colloid used. Hyperchloremic
metabolic acidosis was mostly seen in the NSS group. The length of ICU stay was almost the same in all
groups. There was zero mortality in AIES group as compared to 3 on NSS group and 2 in LRS group.
CONCLUSION AND RECOMMENDATION
Acetated isotonic electrolyte solution is more
effectivethan normal saline and lactated Ringer’s solutions in initial fluid resuscitation among severe
dengue patients. It should be the fluid of choice in the initial resuscitation among severe dengue patients.
It is recommended that a randomized control study with more patients be conducted.
Dengue
7.Prospects for dengue vaccines for travelers.
Sl Ki LIM ; Yong Seok LEE ; Suk NAMKUNG ; Jacqueline K LIM ; In Kyu YOON
Clinical and Experimental Vaccine Research 2016;5(2):89-100
Travel-acquired dengue cases have been increasing as the overall global dengue burden has expanded. In Korea, imported dengue cases have been reported since 2000 when it first became a notifiable disease. During the first four months of 2016, three times more dengue cases were reported in Korea than during the same period the previous year. A safe and efficacious vaccine for travelers would be beneficial to prevent dengue disease in individual travelers and potentially decrease the risk of virus spread to non-endemic areas. Here, we summarize the characteristics of dengue vaccines for travelers and review dengue vaccines currently licensed or in clinical development.
Dengue Vaccines*
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Dengue*
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Korea
8.Circulation of Dengue viruses types in Ha Noi, 1998
Journal of Preventive Medicine 1998;8(3):50-52
A major epidemic of DF/DHF occurred at Ha Noi in 1998, and 3348 cases of have been reported. Serological surveillance confirmed that the epidemic of dengue fever was caused by dengue 3 and dengue 1 virus types 32/37 positive samples were dengue 3 (86.48%). Dengue virus type 3 was isolated in 6 districts of Ha Noi
Dengue Virus
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Dengue
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epidemiology
9.Hypokalemic paralysis associated with dengue fever:Study from a tertiary centre in North India
Rajesh Verma ; Tushar B Patil ; Rakesh Lalla
Neurology Asia 2016;21(1):23-32
Objective: Dengue associated hypokalemic paralysis (DHP) is an unusual neurological complication
of dengue fever. This was a retrospective study of patients with DHP compared with idiopathic
hypokalemic paralysis (IHP) seen in a tertiary centre in North India. Methods: Dengue was diagnosed by
positive nonstructural protein (NS) 1 antigen and dengue-IgM antibody. Various clinical and laboratory
parameters were compared between patients with DHP and IHP. Results: DHP was seen in 18 out of
489 (3.7%) dengue patients seen in the 4-years study period. Complications of bulbar weakness or
respiratory failure developed in 6/18 (33.3%) of DHP patients. DHP patients with complications had
higher hematocrit (p<0.001), lower platelet count (p=0.002), lower serum potassium (p=0.007) and
higher creatinekinase (CK) (p<0.001) as compared to those without complications. When compared to
IHP, DHP patients had fever at admission (p<0.001); myalgia (p<0.001); no past episodes (p=0.032);
greater disability (p=0.02); lower serum potassium (p=0.0338); higher CK (p=0.001); and nerve
conduction abnormalities (p=0.035).
Conclusions: DHP should be suspected in patients who present with acute onset muscle weakness
associated with fever. Predictors of complications in DHP include high hematocrit, low platelet count,
low serum potassium and raised CK.
Dengue Virus
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Dengue