Complications of Severe Dengue

Mostly dengue is like an ordinary viral illness but in a small percentage it can be severe with serious complications. If it is not addressed at the right time, the same can result in complications. The list has been discussed below:

• Shock-
  This is one of the most serious complications which can lead to death and is characterized by low BP. It is due to leakage of fluid from the blood vessels. It is treated by giving intravenous fluids and albumin. Often it responds  but sometimes the leakage does not stop or there is dilatation of blood vessels which becomes untreatable

• ARDS(Pneumonia)-
  This is a very common complication and is due the infection of the lungs by the virus causing pneumonia. Also there is leakage of fluid into the lungs and around the lungs. It results in breathing difficulty due to lack of oxygen. Often the patient has to be put on the ventilator till he improves . This is less serious than shock like state and we have good results for ARDS in our ICU
• Bleeding-
  This is equated with low platelets which has become synonymous with Dengue. Though much feared the seriousness of bleeding as a complication is not so much and direct death from bleeding is not so common. Though sometimes serious bleeding in the brain can also occur. Bleeding occurs because of low platelets and prolongation of APTT (Activated Partial Thromboplastin Time) and PT test (Prothrombin time) which prevents the blood from clotting. Treatment is by giving blood transfusions of platelets and correcting PT APTT by giving transfusions of FFP (Fresh frozen plasma) which is also easily understood as a type of blood minus the rbcs
• Multi-organ failure
  The virus -flavivirus which causes dengue can infect any organ sometimes affecting liver ,kidney , heart etc resulting in failure of these organs called multi-organ failure. this is also serious and can be fatal

The problem in treating Dengue is that treatment is supportive . There is no anti-viral medication which can stop the virus and remove it from the body, there is hope in a vaccine coming soon , but for the time being , dengue if it causes a serious complication continues to be a danger to mankind.