A 4 YEARS OLD BOY WITH DENGUE HAEMORRHAGIC FEVER GRADE III

Giska Tri Putri

Abstract


Dengue Hemorrhagic Fever (DHF) is a frequently encountered case in the practice of general practitioners and emergency department. Dengue is a disease caused by the dengue virus. This infection has several manifestations of asymptomatic to severe cases such as shock. Indonesia is one of the endemic countries with the highest number of reported cases compared to other countries in Southeast Asia. A 4 years old boy with complaints of cold hands and feet since 5 hours before enter to the hospital. Patients had fever 3 days ago. Complaints of fever accompanied by intermittent headache, oftalmic pain, nausea without vomiting, heartburn and decreased appetite. The patient also complained of black feces with soft consistency three times since yesterday, , have not urinating since the morning, and appeared petechiae on the skin. Physical examination found moderate sick in general condition, delirium, blood pressure 90/70 mmHg, heart rate 120 time/min, regular, weak strain and volume, breathing 28 times/min, temperature 36, 3°C. Generalize status obtained pale skin, dry lips and cyanosis, thoracic within normal limits, epigastric pain, liver ¼ - ½, chewy consistency, flat surface, obtuse, cold extremities and positive rumpleed test. Laboratory examination found 35% increasing hematocrit, platelet count of 59,000/ml, positive Dengue Fever Ig M and Ig G. Patients diagnosed with DHF Grade III. Patient receive Intravenous fluid drip (IVFD) Wida Hes 30 drops/min followed by RL 15 drops/min, antacids 3 x ½ teaspoons, paracetamol 3 x ½ tab in emergency department.

Keywords: children, dengue haemorrhagic fever, shock

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