Dengue and the threat of multi-organ failure: Risk factors and early intervention

Dengue fever, a mosquito-borne viral illness, can progress to a life-threatening condition known as multiple organ failure. This article explores the risk factors associated with this severe complication and underscores the importance of early detection and management.
The virus disrupts vascular integrity, leading to fluid leakage from the bloodstream and potentially shock.This can devastate vital organs like the liver, kidneys, heart, and brain. The text highlights warning signs such as liver inflammation, decreased urine output, irregular heartbeat, and neurological changes.
Several factors place individuals at higher risk. Pre-existing medical conditions like diabetes and heart disease emerge as significant concerns, especially for older adults. The article emphasizes that patients aged 40 and above are more susceptible to acute liver failure during dengue.

Clinical presentation also offers valuable clues. Abdominal pain, fluid accumulation, rising haematocrit (red blood cell count), and a rapid drop in platelets are red flags for severe organ involvement. Additionally, the severity of the initial illness is a strong predictor. Early recognition of plasma leakage, a hallmark of severe dengue, is crucial. The text identifies factors like body mass index, platelet count, and elevated liver enzymes as independent predictors of plasma leakage, which can progress to multi-organ failure.
The article emphasizes the importance of early intervention. Close monitoring of patients for warning signs like persistent vomiting, severe abdominal pain, and changes in vital signs is paramount.
The text concludes by underlining the significance of preventive measures. Community-based mosquito control programs and individual use of repellents and protective clothing are essential to curb the spread of dengue and prevent severe complications.
(Dr Haroon H, Internal Medicine, KMC Hospital, Mangalore)