General Practice 2022

Dengue hemorrágica: what é, symptoms, causes and treatment

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Dengue hemorrágica: what é, symptoms, causes and treatment
Dengue hemorrágica: what é, symptoms, causes and treatment

Dengue hemorrhagic fever is a serious reaction of the body to the dengue virus, which leads to the appearance of more serious symptoms than classic dengue and that can endanger the person's life, such as altered heartbeat, persistent vomiting and bleeding, which can be in the eyes, gums, ears and/or nose.

Dengue hemorrhagic fever is more frequent in people who have dengue for the 2nd time, and can be differentiated from other types of dengue around the 3rd day with the onset of hemorrhages after the onset of symptoms of classic dengue, such as pain at the back of the eyes, fever and body pain. See other common symptoms of classic dengue.

Despite being serious, dengue hemorrhagic fever is curable when it is identified in the initial phase and the treatment mainly involves hydration through injection of serum into the vein, for which it is necessary that the person stays in the hospital, because then it is also possible that it is monitored by the medical and nursing staff, preventing the emergence of complications.

Main symptoms

The symptoms of dengue hemorrhagic fever are initially the same as those of common dengue, however after about 3 days more severe signs and symptoms may appear:

  1. Red spots on the skin
  2. Bleeding from gums, mouth, nose, ears or intestines
  3. Persistent vomiting;
  4. Intense abdominal pain;
  5. Cold and damp skin;
  6. Dry mouth and constant feeling of thirst;
  7. Blood urine;
  8. Confusion;
  9. Red eyes;
  10. Change of heart rate.

Although bleeding is characteristic of dengue hemorrhagic fever, in some cases it may not happen, which ends up making the diagnosis difficult and delaying the start of treatment. Therefore, whenever signs and symptoms indicative of dengue are noticed, it is important to go to the hospital, regardless of its type.

How to confirm the diagnosis

The diagnosis of dengue hemorrhagic fever can be made by observing the symptoms of the disease, but to confirm the diagnosis, the doctor may order a blood test and the tie test, which is made by observing more than 20 red dots in a 2.5 x 2.5 cm square drawn on the skin, after 5 minutes of the arm being slightly tightened with tape.

In addition, other diagnostic tests may also be recommended in order to verify the severity of the disease, such as blood count and coagulogram, for example. Check out the main tests to diagnose dengue.

Causes of dengue hemorrhagic fever

Dengue hemorrhagic fever is caused by the bite of the Aedes aegypti mosquito that transmits the dengue virus. In most cases of dengue hemorrhagic fever, the person has had dengue before and when they are reinfected with the virus, they develop more severe symptoms, resulting in this type of dengue.However, some people who have never had dengue may already have the most severe form of the disease.

In addition, the use of some drugs that were not recommended by the doctor for the treatment of dengue can favor the development of dengue hemorrhagic fever, as they can stimulate bleeding and lead to complications.

How the treatment is done

Treatment of dengue hemorrhagic fever must be guided by a general practitioner and/or by an infectious disease specialist and must be carried out in the hospital, as hydration is required directly in the vein and monitoring of the person, since in addition to dehydration it is possible that liver, heart, respiratory or blood changes may occur.

It is important that treatment for dengue hemorrhagic fever is started within the first 24 hours after the onset of symptoms, which may require oxygen therapy and blood transfusions.

It is recommended to avoid the use of medications based on acetylsalicylic acid, such as AAS and anti-inflammatory drugs such as Ibuprofen, in case of suspected dengue.

5 common questions about dengue hemorrhagic fever

The following are the main doubts about dengue hemorrhagic fever:

1. Is hemorrhagic dengue contagious?

Dengue hemorrhagic fever is not contagious, because like any other type of dengue, it takes the bite of the Aedes aegypti mosquito infected with the virus to develop the disease. Thus, to prevent mosquito bites and the emergence of dengue, it is important to:

  • Avoid dengue epidemic sites;
  • Use repellents daily;
  • Light a citronella scented candle in each room of the house to ward off the mosquito;
  • Put protective screens on all windows and doors to prevent mosquitoes from entering the house;
  • Consume foods with vitamin K that help with blood clotting such as broccoli, cabbage, turnip greens and lettuce that help prevent hemorrhagic dengue.
  • Respect all clinical guidelines regarding dengue prevention, avoiding dengue mosquito breeding sites, not leaving clean or dirty water standing anywhere.

These measures are important and must be followed by the entire population in order to reduce dengue cases in the country. Check out in the video below some other tips to keep the mosquito away from dengue:

2. Does hemorrhagic dengue kill?

Dengue hemorrhagic fever is a very serious disease that must be treated in hospital because it is necessary to administer medication directly into the vein and oxygen mask in some cases. If treatment is not started or is not done correctly, dengue hemorrhagic fever can lead to death.

According to severity, dengue hemorrhagic fever can be classified into 4 degrees, in which the mildest symptoms are milder, and bleeding may not be observed, despite the positive tie test, and in the most severe it is possible that there is shock syndrome associated with dengue, increasing the risk of death.

3. The first time is never dengue hemorrhagic fever?

Despite being rarer, dengue hemorrhagic fever can occur in people who have never had dengue, in which case babies are the most affected. Although it is not yet known exactly why this can happen, there is knowledge that the person's antibodies can bind to the virus, but cannot neutralize it and therefore it continues to replicate very quickly and cause serious changes in the body.

In most cases, dengue hemorrhagic fever occurs in people who have been infected by the virus at least once.

4. Could it be caused by using the wrong medicine?

Inappropriate use of medication can also favor the development of dengue hemorrhagic fever, as some drugs based on acetylsalicylic acid, such as ASA and Aspirin, can promote bleeding and hemorrhage, complicating dengue. Check out how to treat dengue to avoid complications.

5. Is there a cure?

Dengue hemorrhagic fever is curable when it is identified and treated quickly. It is possible to be completely cured, but this requires going to the hospital as soon as the first symptoms of dengue appear, especially if there is a lot of abdominal pain or bleeding from the nose, ears or mouth.

One of the first signs that may indicate dengue hemorrhagic fever is the ease of getting purple marks on the body, even in small blows, or the appearance of a dark mark where an injection was given or blood was drawn.

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