Dengue fever, caused by the dengue virus transmitted through Aedes mosquitoes, can lead to severe illness, especially in critically ill patients. Current efforts primarily focus on vector control to prevent transmission (Bhatt et al., 2013). Critically ill patients with severe dengue are at risk of developing concurrent bacterial infections, emphasizing the need for early diagnosis and prompt antibiotic treatment (Chen et al., 2016; Chen et al., 2016). Inflammation plays a crucial role in dengue severity, with studies investigating inflammation mediators to optimize treatment strategies (Zhao et al., 2016). Close monitoring, timely resuscitation, and correction of complications are vital in preventing the progression of dengue severity in adult patients (Lee et al., 2016).
Thrombocytopenia, a common complication in dengue, is associated with severe plasma leakage leading to shock and organ impairment, necessitating emergency treatment and urgent referral during the critical phase of the disease (Azeredo et al., 2015). Prognostic factors determining the outcomes of critically ill dengue patients remain unclear (Padyana et al., 2019). Biomarkers like peripheral venous lactate and serum ferritin show promise in early recognition and prognostication of severe dengue (Thanachartwet et al., 2015; Suresh et al., 2020). However, the utility of basic arterial blood gas parameters and lactate as prognostic markers in severe dengue patients requires further investigation (Gupta et al., 2022).
In the absence of specific antiviral treatments, supportive care remains the mainstay for managing severe dengue cases (Schwartz et al., 2015). Diagnostic approaches involving the detection of dengue virus-reactive antibodies can aid in confirming dengue infections (Simmons et al., 2012). The pathogenesis of severe dengue involves vascular leak, which progresses through distinct clinical phases (Malavige & Ogg, 2017). Patients with severe dengue may develop complications like hemophagocytic syndrome, emphasizing the need for vigilant management (Kobayashi et al., 2015).
Studies on the clinical profiles and factors associated with mortality in dengue patients highlight the significance of thrombocytopenia as a marker of disease severity (Amâncio et al., 2015). Early identification and treatment are crucial in reducing mortality in patients with dengue shock syndrome (P et al., 2022). Liver injury in dengue varies with disease severity, with severe cases exhibiting distinct clinical manifestations (Mohindra, 2023). Serum ferritin levels may serve as early predictors of severe dengue, aiding in timely intervention (Petchiappan et al., 2019).
In conclusion, managing critically ill patients with severe dengue requires a multidisciplinary approach involving early diagnosis, vigilant monitoring, and prompt treatment of complications. Biomarkers, clinical risk scores, and supportive care play essential roles in improving outcomes for these patients.
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