Patients with marked plasma leakage, may develop shock, especially if treatment is delayed and is associated with case-fatality rate of 12%.
The number of dengue patients have been on the rise, as the virus is transmitted by the bite of an infected Aedes mosquito. “Plasma leakage is the most specific and life-threatening feature of dengue which occurs three to seven days after the onset of the illness,” says says Dr KK Aggarwal, President HCFI & Honorary Secretary General IMA and a Padma Shri awardee.
It is important to be aware of dengue's most life-threatening aspect, even though 99% of dengue cases are non-fatal,
Dengue is both preventable and manageable and fatalities occur only in 1% of the cases, says Aggarwal.
Read: Dengue- Facts and prevention measures
Aggarwal says that chest radiography and chest/abdominal ultrasound are useful for detection of plasma leakage.
Symptoms of Plasma leakage
- Abdominal pain (60% of patients with dengue report it to precede plasma leakage)
- Persistent vomiting
- Marked restlessness or lethargy, especially coinciding with defervescence
Over a period of 24 to 48 hours, plasma leakage leads to increase in vascular permeability, which is the ability of small molecules or even whole cells to flow in and out of a blood vessel wall.
Patients with marked plasma leakage, may develop shock, especially if treatment is delayed and is associated with case-fatality rate of 12%. In mild cases, when medical attention is received early, oral rehydration may be sufficient.
It is important to manage plasma leakage with intravascular volume repletion to prevent or reverse hypovolemic shock. However, in patients with established intravascular volume loss, it is recommended to administer intravenous fluid.
Blood transfusion is only appropriate in patients with significant bleeding or those who have low hematocrit and fail to improve despite fluid resuscitation.
A platelet transfusion should be considered if platelet counts are more than 10,000, as an unnecessary platelet transfusion can cause more harm.
Also Read: What are the risks of platelet transfusion in dengue patients?
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