PATHOPHYSIOLOGY

Dengue Fever + Febrile Seizure

Dengue fever is sourced by a mosquito-borne viral disease that is transmitted by female mosquitoes
mainly of the species Aedes aegypti. A febrile seizure is a convulsion in a child caused by a spike in body
temperature, often from an infection. They occur in young children with normal development without a history of
neurologic symptoms.

Precipitating Factors: Predisposing Factors:

 Patient living in Phase 1, Sta.  3 years old (belong the to risk

Cruz, Camaman-an group)
 Congested living condition  Economic status
 Diet: rice, fish, vegetables

Bites of Aedes Egypti

Virus penetration to skin

Virus infects and replaces

Langerhans cell (immunity
of the skin)

Nursing management: Langerhans cell release

 HAI: interferon (to limit the
- Wear protected equipment spread of infection)
when handling body fluids
- Effective handwashing
- Avoidance of urinary Virus infects and replaces
catheterization Langerhans cell (immunity
- Frequent oral care of the skin)
 Cough:
- Nebulization
- Chest tapping
Infected Langerhan cells
- Increased O2
go to the lymphatic (alert
the immune system)
hindi
kinakailangang
Then goes to the
Nosocomial Infection (HAI) may circulation
interaksyon
(bacteria streptococcus)
agad sa kapwa
 (+) cough upang maipamalas
Results in viremia (high
DATE PLATELET WBC
 s/sx: levels of the virus in the
- Discharge from wound ang kagandahang-
bloodstream) Nov. 29, 2019 243 9
- Cough loob. Ang Dec. 3, 2019 150 52
- Fever
- Burning or difficulty pagpapahalagang
Activation of the Dec. 4, 2019 130 62
immune response
when urinating ito ay maaaring Dec. 5, 2019 165 50
- Headache
- Nausea, vomiting, magamit na gabay Reference range: 150-390 20-50
Endogenous pyrogens
diarrhea sa kung ano ang
mga nararapat na
ipakitang kilos,
Production of pro-inflammatory cytokines

may kapwa man o

Disidurin syrup
wala. Ito ay isang
katangiang
 Hypothalamic control

Release of prostaglandin E2

Anterior hypothalamus

Elevated thermoregulatory set-point

Heat conservation Heat production

Fluid conservation Metabolism of the Liver

Vasoconstriction Glucose breakdown

Irritable and Energy

Cerebral perfusion Muscle contraction demand
restlessness

Fever Paracetamol
Temperature fluctuates:
First day of confinement:
39.5C
salbutamol
Febrile Phase Clinical sign:
(2-4 days) • High fever (1st day of confinement:
Bronchospasm Neuronal excitability 39.5C)

Management
Breathing difficulty • Reduction of high fever: paracetamol
Febrile seizure only, tepid sponge
• Promote oral feeding: soft diet, milk,
Evidenced by fruit juice, oral rehydration solution
respiratory rate: (ORS). Avoid IV fluid if there is no
38 bpm vomiting and moderate/ severe
dehydration
• Follow up CBC everyday
Complications
• Advise to come back to the hospital
ASAP when there is no clinical
improvement despite a lack of fever,
If managed: If not managed: severe abdominal pain/ vomiting,
bleeding, restless/irritable, drowsy,
In getting back to Dengue hemorrhagic fever - a refusal to eat or drink (some patients
normal, patient will potentially fatal complication of may be thirsty), urine not passed for 4–
feel very weak and dengue that can cause an enlarged 6 hours.
unwell for a while. liver and, in severe cases, can lead to
Most people recover shock (a sudden drop in blood
within two weeks, pressure).
although it can  Admit patients with
sometimes take Dengue shock syndrome (DSS) - a Critical Phase thrombocytopenia and poor
months for you to get complication of dengue hemorrhagic appetite/ poor clinical conditions.
back to normal. fever. Symptoms of shock include:  Proper IV fluid management
- a sudden drop in blood
pressure
- cold, clammy skin
- a weak rapid pulse Stop IV fluid when there are signs of
Recovery Phase
- dry mouth recovery.
- irregular breathing
- dilated pupils
- reduced flow of urine