Dengue: find out what worsening symptoms are – 02/15/2024 – Balance and Health

The classic clinical picture of dengue manifests itself with fever, joint pain and the appearance of red spots on the skin. However, experts warn that worsening after the first few days and the emergence of new symptoms may indicate a worsening of the condition.

Ralcyon Teixeira, infectious disease doctor and director of the Medical Division at Hospital Emílio Ribas, points out that in addition to headaches, behind the eyes, in the joints, nausea, vomiting and red spots on the skin, those infected with dengue may show signs of worsening such as pain intense and continuous abdominal; a lot of agitation or drowsiness, dizziness, fainting and cold, pale skin.

“The most serious thing would be the reduction in blood pressure, but this is more noticeable in the hospital — it’s what we call shock”, says Teixeira.

The recommendation in these cases, according to the doctor, is to immediately seek hospital emergency care. In children, persistent crying also needs to be taken into consideration.

The infectious disease specialist also highlights that some populations are at greater risk of having the aggravated version of the disease. The group is made up of people over 65 years of age, children under 2 years of age, pregnant women and patients with comorbidities such as high blood pressure, cardiovascular diseases, obesity, liver disease, autoimmune diseases, among others.

“We must also always be concerned about those who are at social risk — they live alone, without the support of someone to help take care of them”, reinforces Teixeira.

The initial stage of dengue fever generally lasts two to seven days. “In this febrile phase, you have a lot of body pain and, often, abdominal pain, nausea, sometimes intestinal symptoms, diarrhea and vomiting”, points out Paulo Camiz, geriatrician and professor at USP (University of São Paulo) and the Hospital of the Clinics of the Faculty of Medicine of the University of São Paulo (HC-FMUSP).

The biggest problem arises when, at the end of this period, between the fourth and fifth day of the illness, the patient begins to show clinical worsening. “If the person is really not improving, even starting to have a drop in blood pressure or spots on the body, which could indicate a sign of bleeding, this is a sign of severity. You have to be careful, because it can develop into hemorrhagic dengue, which is very serious”, warns Camiz.

The clinician recommends that, in these cases, on the third day without improvement, the patient seeks the nearest emergency room to receive help. “Look for a hospital to at least do tests and see if you are not heading towards hemorrhagic dengue fever, which consists of a drop in platelets and, often, an increase in hematocrits, because the person becomes dehydrated”, says Camiz.

Monitoring the platelet concentration through blood collection is the main indication for doctors to discover whether the disease is at a critical stage. “Not necessarily [a pessoa] she will be hospitalized, but she can see how the situation is”, ponders the geriatrician.

If there is any doubt that the high fever could be dengue and not another problem, the tip is to check for respiratory symptoms, such as shortness of breath.

“[O que] What attracts a lot of attention in relation to dengue are the feverish symptoms, with a lot of pain in the body and a lot of discomfort. Another thing is the absence of respiratory symptoms”, says Camiz.

“Respiratory diseases continue to circulate. Not every febrile illness at the moment is dengue — this is a warning that applies to both the population and health professionals. Be careful with other infectious diagnoses”, says Teixeira.

Another important warning is not to use acetylsalicylic acid for fever or anti-inflammatory drugs for pain if dengue is confirmed or suspected, as these medications can worsen the condition and trigger hemorrhagic dengue fever in the patient.