Table of contents

Introduction

Case presentation

Prevention

Conclusion

Case # 4173774

1. Bressel Ken Blanco Bancale is an 11-year-old female who was diagnosed with dengue fever
and has been admitted at March 4, 2023 (09:30 AM) in the Pediatric Ward. There are 5
members of the family named Ginalyn Bancale (mother), Vincente Bancale( father), Jovinc
Bacale (brother), and Nathaniel Bancale (brother) who live in Purok 2, Talisay, Malaubang
Ozamiz City. The beneficiary that they have is Phil's health.

3.March 4, 2023

Bp: 90/60

PR: 139 BPM

RR: 19 CPM

O2SAT: 98%

T: 38.4 ◦C

Height: 152 cm

Weight: 52 kg

March 06, 2023

Bp: 100/60

PR: 72 BPM

RR: 22 CPM

O2SAT: 96%

T: 39

March 07, 2023

Bp: 100/60
PR: 96 BPM

RR: 23 CPM

O2SAT: 97%

T: 36◦C

Complaint:

On and off fever X 3 day’s abdominal pain, dizziness

Admission Diagnosis:

Dengue fever with warning signs

Symptoms:

Abdominal cramp/pain, Body pain, Fever, Anorexia, Vomiting

Patient COUNSELLING:

 Take plenty of rest.

 Drink plenty of fluids.
 Avoid spicy, oily, canned food.
 Eat fruits and fresh vegetables.
 Walk in fresh environment for about 5-10 minutes.
 Eat papaya leaf extract.
 Always be happy and avoid stress.

PLAN FOR TREATMENT

Goals of treatment:
- To reduce chills, fever, body pains.

To increase platelet count.

To provide symptomatic relief.

To improve quality of life.

Monitor parameter:

Disease specific- monitor vital signs, weight of a patient and symptoms of the patient, as in dengue fever
the platelet count is decreased it must be monitored

Physical Examination:

[Head, Eyes, Ears, Nose, Throat]: Dry mucous membranes

Chest/Lungs: Essentially Normal

CVS: Essentially Normal

Abdomen: Abdomen Tenderness

GU [IE]: Essentially Normal

Skin: Essentially Normal

Neuro: Essentially Normal

2. Case presentation

Bressel Ken Blanco Bancale is an 11-year-old female has been admitted at March 4, 2023 (09:30 AM)
in the Pediatric Ward with 5-day history of continuous fever and no consult done, given Paracetamol
which provided mild relief. Condition persisted, now associated with fair appetite and not tolerating oral
medication hence admitted. She became more unwell on the day of admission with recurrent bouts of
vomiting, abdominal pain, and reduced urine output. Further discussion showed that her neighbor
had a similar illness requiring admission to the hospital a week ago.

4.Lab result: (3/8/2023)

WBC: 4.9
RBC: 5.11

Hmglbn: 14.5

Hematocrit: 43.7

MCV: 86

MCH: 28.3

MCHC: 33.1

Platelet: 45

Doctor’s Oder

IVF: PLR 1c @ 20 gtts/min

Paracetamol 300 mg IV Q4hrs PRN

Omeprazole 40 mg W now then Q24hrs

Zinc sulfate syrup, 10 ml OD

Lab result. 3-4-23

 WBC : 4.9
 Hematocrit: 43.7
 MCV : 86
 MCH: 28.3
 Hmglb : 28.3
 MCHC: 33.1
 Platelet: 45

Differential count:

 Neutrophils: 34
 Monocytes: 21
 Basophils: 1
 Lymphocytes: 41
 Eosinophils: 3
 RDW: 13.2
Lab result. 3-8-23

 WBC : 4.9
 Hematocrit: 43.7
 MCV : 86
 MCH: 28.3
 Hmglb : 28.3
 MCHC: 33.1
 Platelet: 45

Differential count:

 Neutrophils: 34
 Monocytes: 21
 Basophils: 1
 Lymphocytes: 41
 Eosinophils: 3
 RDW: 13.4

Lab result: 3-5-23

 WBC : 2.2
 Hematocrit: 43.9
 MCV : 87
 MCH: 28.3
 Hmglb : 14.3
 MCHC: 32.5
 Platelet: 51

Differential count:

 Neutrophils: 55
 Monocytes: 15
 Basophils: 1
 Lymphocytes: 28
 Eosinophils: 0
 RDW: 13.6
 What is dengue?
Dengue is a viral infection. It can be caused by four related viruses. You can get it if an
infected mosquito bites you. It is common in warm, wet areas of the world. Although rare, it can be
found in some parts of the United States. Outbreaks are more common during rainy seasons.
How does dengue spread?
Dengue spreads to people through the bite of an infected mosquito. It does not spread directly from
person to person. However, a pregnant person can pass the infection on to the baby. In rare cases,
it can spread through a blood transfusion, organ transplant, or needle stick injury.

What are the symptoms of dengue and severe dengue?

About one in four people infected with dengue will get sick. For those who do get sick, the infection
can be mild or severe. The symptoms of dengue include:

 A high fever
 Nausea and vomiting
 Rash
 Aches and pains (eye pain, usually behind the eyes, and pain in the muscles, joints, or bones)
The symptoms usually last two to seven days.

Severe dengue is a serious form of the illness. About 1 in 20 people who get sick with dengue will
develop severe dengue. It can cause shock, internal bleeding, and even death. People are more
likely to develop severe dengue if they have had dengue before, are pregnant, or are infants.
Watch for signs and symptoms of severe dengue. Warning signs usually begin about 24 - 48 hours
after your fever has gone away. If you or your family member have these signs, get immediate
medical care:

 Severe abdominal (belly) pain and tenderness

 Vomiting at least 3 times in 24 hours
 Bleeding from the nose or gums
 Vomiting blood, or blood in the stool
 Feeling tired, restless, or irritable

How is dengue diagnosed?

There is a blood test which can show if you have been infected with dengue.
What are the treatments for dengue?
There is no specific medicine to treat dengue. Most people will get better after about a week. But if
you think you might have dengue:

 See a health care provider and mention any recent travel.

 Rest as much as possible.
 Take acetaminophen to control fever and relieve pain. But do not take aspirin or ibuprofen.
 Drink plenty of fluids.
 Severe dengue often requires care at a hospital.

Can dengue be prevented?

There is a vaccine to prevent dengue. It is approved for children ages 9 - 16 who have previously
had dengue and live in areas where dengue is common.

You can also help prevent dengue by avoiding mosquito bites:

 Wear insect repellent with DEET or another U.S. Environmental Protection Agency (EPA)-registered insect
repellent. Make sure to follow the instructions for using the repellant.
 Wear clothes that cover your arms, legs and feet.
 Close unscreened doors and windows.