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Save the life of a case of severe dengue shock in an infant

Recently, the Department of Emergency and Resuscitation at City Children’s Hospital received a case of an infant in severe hemorrhagic shock. It’s young CB. NG. TD 7 months old, male, living in Dong Thap. The patient’s medical history recorded 4 days, days 1-3: mild fever, loose stools more than 10 times/day, thick yellow stools without blood, moderate amount, vomiting 3-4 times/day

Day 4: fever decreased, diarrhea 4-5 times from morning, no blood, vomiting 1 time, went to a private clinic to take medicine of unknown type, when I got home I was sleeping, I had a convulsion 1 time, my eyes widened and my family member take the child to a general clinic near home, receive oxygen therapy, anticonvulsant with diazepam, transfer to the City Children’s Hospital, on the way the child continues to have convulsions. In the emergency department, the child still had generalized convulsions, cyanosis, cool extremity shock, CRT 3-4 seconds pulsating pulse slightly 200 times/min, blood pressure difficult to measure was diagnosed: hypovolemic shock – Infective diarrhea – Sepsis from the gastrointestinal tract. Differential diagnosis with septic shock, severe dengue hemorrhagic shock. Treated intubation, mechanical ventilation, anti-shock, anticonvulsant fluids, antibiotics, adjustment of water, electrolytes, acidosis and blood metabolism. Blood tests showed NS1 antigen rapid test results, diagnosis was positive for dengue fever, severe liver damage, liver enzymes increased over 4000 units/L (normal < 40 units/L), severe coagulopathy, decreased blood albumin. heavy. Children continued to receive anti-infusion, albumin, vasopressor drugs, blood transfusion, fresh frozen plasma, cold precipitate, platelet concentrate, liver support therapy. Severe respiratory failure, peritoneal drainage to decompress, continue to correct metabolic acidosis, electrolytes. Results after more than 1 week of treatment, her condition improved gradually, she was weaned from the ventilator, was awake, and could breastfeed. This is one of the cases of dengue shock in infants. The fever is not high and accompanied by digestive symptoms, so parents and even medical staff are easily caught off guard with dengue fever. Digestive disorders, infectious diarrhea leading to late hospitalization.

  Acute poisoning of substances causing blood Methemoglobin in children: Danger is always lurking.

By the way, please also note that parents, currently in the rainy season, is the time when mosquitoes develop and transmit dengue fever to children, parents should pay attention to take good preventive measures such as eradicating dengue fever. mosquitoes, mosquitos, bed nets, etc., and when you see your child has a high fever for more than 2 days, shows one of the following signs, it is necessary to take the child immediately to the hospital.

  • Irritability, rolling over or lethargy, lethargy, slurred speech
  • Nosebleeds, bloody teeth or vomiting blood, black stools
  • Abdominal pain, vomiting
  • Cold hands and feet
  • Lethargy, lying in one place not playing or giving up breastfeeding, eating and drinking
Young CB.  NG.  TD 7 months old, male, severe dengue shock, severe liver damage, actively treated with mechanical ventilation, anti-shock, correction of coagulation disorders, liver support
Young CB. NG. TD 7 months old, male, severe dengue shock, severe liver damage, actively treated with mechanical ventilation, anti-shock, correction of coagulation disorders, liver support
After more than 1 week of treatment, her condition gradually improved, she was weaned from the ventilator, was awake, and breastfed quite well.
After more than 1 week of treatment, her condition gradually improved, she was weaned from the ventilator, was awake, and breastfed quite well.

Doctor 2 Nguyen Minh Tien
City Children’s Hospital



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