Cornerstone treatment of dengue fever with warning signs without shock or hemorrhage is:
Ans. (B) IV fluids(Ref: Harrison's Principle of Internal Medicine 20th Ed; Page No-1508)The mainstay treatment for a patient of dengue with warning signs is IV fluids.The main pathology in dengue is plasma leakage resulting in intravascular volume depletion and thereby shock. So, the supportive management with continuous infusion of crystalloid IV fluids remains the primary modality of treatment in these patients. And often patients respond well to supportive management.Platelet transfusion is limited to patients with severe thrombocytopenia (<10,000/mm3) and active bleedings.Cryoglobulins are not preferred treatment modality in dengue.Clinical PearlsWarning Sign of Severe DengueIt occur 3-7 days after 1st symptoms in conjunction with a decrease in temperature (below 38degC/100degF) and include:#Severe abdominal pain#Persistent vomiting#Rapid breathing#Bleeding gums#Fatigue#Restlessness and#Blood in vomitThe next 24-48 hours of the critical stage can be lethal; proper medical care is needed to avoid complication and risk of death.In patient management is advised to all patient of dengue with warning signs.
Platelet transfusion
IV fluids
Cryoglobulins
Antivirals
Blood