Last week, the Emergency Department – City Children’s Hospital received 2 cases of dengue fever with respiratory failure, blood clotting disorder, and severe liver damage. In the case of the first child LAS 12 years old, male living in Tan Phu district, sick for 4 days, the child had a high fever continuously, vomiting and diarrhea 4-5 times, the family thought the child had a digestive disorder, so they bought medicine for the child to take but did not. children with cold hands and feet should be taken to a local hospital in a state of mild pulse shock with cool extremities, persistent blood pressure of 80/60mmHg, negative SARS-CoV-2 rapid test, positive NS1 antigen test, diagnosed with severe dengue hemorrhagic fever on day 4, respiratory failure, coagulopathy, anti-shock fluids, unfavorable progress should be transferred to City Children’s Hospital. Second youngest case Ph. Ph. Q. 12 years old, male living in Sa Dec, Dong Thap hospital, sick for 5 days, child has high fever continuously, abdominal pain, vomiting, family members have taken the child to private clinic but it does not help, child has a lot of stomach pain, vomiting. Brown swine fever, cold hands and feet, should be taken to a local hospital in a state of mild pulse shock, cool extremities, blood pressure of 70/50mmHg, rapid test for SARS-CoV-2 is negative, rapid test for NS1 antigen is positive The patient was diagnosed with severe dengue hemorrhagic fever on day 5, respiratory failure, liver damage, coagulation disorder, receiving anti-shock fluids according to the protocol, he showed shortness of breath, distended abdomen, elevated liver enzyme tests on 1000 units/L (normal liver enzymes AST, ALT < 40 units/L) should be transferred to City Children's Hospital. Here, 2 children were recorded with shock, light tachycardia, blood pressure 90/70mmHg, dyspnea, melena, distended abdomen, abdominal and chest ultrasound showing peritoneal effusion, pleural effusion moderate, blood tests showed that both children had severe liver damage and severe coagulopathy. The treated children continued to receive anti-shock macromolecule fluids with the help of invasive arterial sphygmomanometers, central venous pressure measurement, respiratory support with continuous positive pressure breathing, correction of coagulopathy. Results after more than 1 week of treatment, so far the children's condition has gradually improved, awake, breathing fresh air.
The early rains of the season signal that the dengue epidemic season is near, both medical staff and parents must not be subjectively late to detect, bring children to hospital late, but must always think that the child may have dengue fever. blood when having a fever, not just worrying about the child having COVID-19 or another disease. Parents need to monitor and detect early signs to take their children to a medical facility in time. That is, if you see a child with a high fever for more than 2 days, showing one of the following signs, you need to take the child to the hospital immediately, even at night.
- Irritability, irritability, irritability or lethargy
- Nosebleeds, bloody teeth or vomiting blood, black stools
- Cold hands and feet, lying in one place not playing, giving up sucking, eating and drinking
Doctor of CK2 Nguyen Minh Tien
City Children’s Hospital