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Diagnosed dengue, low platelet and leucocytes. Taking orio and parafiz. Given papaya leaf juice. What further course of medication is essential?

hello doc My brother has been daignosed Dengue wiith only NS1/AG as positive and Antibody IgM and IgG as negative.This was as per yesterday when his platelet count was 1.5 lakh and total leucocytes as 2800 cells/cu.mm. As per today morning sample the total WBC are 4000 and platelet has fallen further to 1.2 lakh. He is still at home with basic medication of Orio and parafiz(for fever 4 times a day). I have also given him papaya leaf juice twice since yesterday........... Pl suggest is the situation normal...........or what further course of medication is required.
Asked On : Sat, 28 Jul 2012
Answers:  4 Views:  282
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Internal Medicine Specialist 's  Response
Hi,

Welcome to Healthcaremagic,

Thanks for posting your query to this forum,

Dengue fever is viral fever which occurs due to virus and vector is mosquito Aedes,

Medical treatment of acute dengue is supportive ,by oral or intravenous rehydration for mild or moderate disease, and intravenous fluids and blood transfusion,Platelets or plasma in severe cases. Platelets count is correlated with symptoms and bleeding clinically to decide about the use of transfusion or platelets.

Patient should be carefully monitored by Platelet count regularly and if required Liver function test, Kidney function.

In most of the cases spontaneous recovery occurs and platelet count also improves but it should be monitored to detect early complication if any.

dengue hemorrhagic fever or dengue shock syndrome low platelet count or shock which occurs in very less % of cases.

Hope your brother recovers soon wish him a speedy recovery.

Take care



Good Luck.

Dr. Akhilesh dubey M.D.



Answered: Mon, 29 Apr 2013
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General & Family Physician Dr. Siddartha's  Response
Hello
welcome to health care magic
Dengue fever is transmitted by Aedes mosquitoes..it includes symptoms like sudden-onset fever, headache, muscle and joint pains..etc.,,normal blood platelet count is 1.5 to 4 lakhs...
In dengue fever platelet count comes down to less than 1 lakh or even to fifty thousand...
but that doesn't require a platelet transfusion...
When you have bleeding from the nose,bleeding gums,petechiae(dark spots on the skin)and also on the tongue,,black colored stools,you need platelet transfusion immediately..other wise not required..
Mean while your liver function is altered because of dengue
Antibiotics are given to stop the secondary bacterial infection..
No dietary restrictions for this fever..you can take what ever you want..
In untreated cases it may progress to dengue hemorrhagic fever and dengue shock syndrome..

consult general physician and take necessary steps and medications..
Hope you understand my suggestion
Have a speed recovery
Thank you
Dr.siddartha
Answered: Thu, 2 May 2013
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  Anonymous's Response
Ok for this ..u should continue antibiotic ,then get a regular platelet count investigation,if it fall down less then 50000 ar have a active bleed u would need platelet transfusion
Answered: Tue, 4 Sep 2012
  Anonymous's Response
ANTIBIOTICS HAS NO ROLE IN DENGUE FEVER AND BECAUSE YOU SAY IT IS NS1 AG POSITIVE I PRESUME IT IS DENGUE INFECTION (ANTIBODIES TO IGM AND IGG CAN BE NEGATIVE IF TESTED LESS THAN 7 DAYS INTO ILLNESS).
PLATELETS WILL CONTINUE TO DECREASE TILL 7 - 8 DAYS OF ILLNESS AND IT INCREASES AUTOMATICALLY AFTER THAT, WHEN SHOULD WE GET WORRIED IS WHEN HE STARTS HAVING BLEEDING(LIKE BLEEDING FROM NOSE, GUMS, BLOOD TINGED VOMITUS, BLACKISH COLOURED STOOLS) THAT MEANS HIS PLATELETS ARE REALLY LOW AND HE NEEDS URGENT PLATELET TRANSFUSION.
DIFFERENT HOSPITALS HAVE DIFFERENT CRITERIAS TO TRANSFUSE PLATELETS. BUT ACCORDING TO THE STANDARD WHO CRITERIA UNLESS A PATIENT BLEEDS HE DOES NOT NEED TRANSFUSION.
ANTIBIOTICS ARE GIVEN WHEN YOU ARE IN DOUBT WHETHER YOU HAVE DENGUE FEVER OR OTHER ILLNESS.
THE MAINSTAY OF TREATMENT IS FLUIDS(THOUGH THERE IS THIRD SPACING - ACCUMULATION OF FLUID IN EXTRAVASCULAR SPACE) THERE IS LOSS OF FLUID IN THE INTRAVASCULAR COMPARETMENT WHICH LEADS TO HEMOCONCENTRATION. HENCE ASK HIM TO DRINK PLENTY OF ORAL FLUIDS.MONITOR THE PLATELET COUNT AND BLEEDING PARAMETERS REGULARLY.
DON NOT PANIC.
HOPE I HAVE ANSWERED YOUR QUERIES.
REGARDS.
Answered: Mon, 29 Apr 2013
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