Bleeding during dengue fever: Warning signs of thrombocytopenia

The article was professionally consulted with Master, Doctor Nguyen Thi Nhat - Infectious Diseases Doctor - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

The most common complication of dengue fever is thrombocytopenia. However, thrombocytopenia in dengue fever usually does not make the body tired and lethargic, so the patient is subjective and does not follow up until massive bleeding is life-threatening.

Dengue virus is the cause of hemorrhagic fever, most of the vectors are transmitted by the Aedes aegypti mosquito, which transmits the virus from an infected person to a healthy person through a bite.
Dengue virus has 4 strains, so a person can get dengue more than once in a lifetime. Dengue fever is a dangerous disease that can affect people of all ages. The disease can lead to shock, blood clotting disorders, multi-organ failure... even death if not treated promptly.
2 The 2 most commonly fatal complications of dengue are thrombocytopenia and hemoconcentration. In particular, dengue fever reduces platelets without making the body tired and lethargic, so patients are often subjective and do not monitor until massive bleeding, which is life-threatening.

Thrombocytopenia is a criterion for assessing the severity of dengue fever. Thrombocytopenia is defined as a platelet count below 150,000/mm3. Hemorrhagic fever low platelets means that the blood has lost its ability to clot and is unable to fight off infections. Dengue fever causes thrombocytopenia is due to:
Inhibition of bone marrow, bone marrow is the site of platelet production. Dengue fever causes thrombocytopenia because the blood cells are affected by the virus that causes platelet damage. In dengue fever, the antibodies destroy a large number of platelets causing the platelets to be reduced.

Usually, the platelet count drops sharply when the illness is in the 4th day. The symptoms of thrombocytopenia in dengue include:
Bleeding with dengue fever: This is a warning sign of thrombocytopenia. Usually severe skin bleeding, typically spots of blood on the skin and large patches of blood under the skin. Black stools due to gastrointestinal bleeding and blood in the urine Dengue Fever abnormal menstrual bleeding in patients Plasma leakage or respiratory failure, liver failure, heart failure and other organ failure Crystals Mental illness, altered consciousness, weakness The patient shows signs of lethargy and continuous vomiting When hemorrhagic fever bleeds from the teeth, the patient may be experiencing complications of thrombocytopenia.

To identify thrombocytopenia in dengue fever, the doctor will do tests for IgG and IgM antibodies, PCR test, blood count test. The treatment of thrombocytopenia in dengue patients includes:
Platelet transfusion: There is no limit to the indications for platelet transfusion when thrombocytopenia in dengue fever. The elderly and those with chronic illnesses can still transfuse platelets when the white blood cells overreact. Iron supplementation: Iron helps in the production of healthy blood cells, important for health and platelet count in dengue fever. Foods rich in iron such as pumpkin seeds, lentils, beef... Vitamin C: Vitamin C will help platelets work more efficiently. At the same time, vitamin C also helps absorb iron, increases the number of platelets in dengue fever. Mangoes, pineapples, broccoli, bell peppers, tomatoes, ... are foods rich in vitamin C. Omega-3 and other minerals will help fight antibodies, increase platelet count. Patients can eat fruits such as papaya, ca... to help increase platelet count. Vitamin B12: This is a vitamin that helps the body keep blood cells healthy. Beef liver, oysters, dairy products... are foods that increase platelet count.

Dengue fever is a disease that currently has no vaccine to prevent, so the main prevention is the following methods:
Seal all water containers such as drinking water tanks, wells, jars, and jars. , buckets...; remove waste materials to prevent mosquitoes from laying eggs, causing more reproduction and proliferation. A method of killing larval mites or larvae can also be used by placing the fish in a large container of water. Wear long clothes, sleep under a mosquito net, use mosquito spray, mosquito repellent cream, curtains or mosquito nets impregnated with insecticides, etc. to prevent mosquito bites. Actively coordinate with the health sector in chemical spraying for epidemic prevention and control. Because there is a risk of becoming an epidemic anywhere, it is necessary to propagate and raise people's awareness to successfully control dengue fever. If someone in the family has dengue fever, the patient needs to be isolated and when showing signs of fever, it is necessary to immediately go to a medical facility for appropriate examination, diagnosis and treatment to avoid dangerous complications. In case of seeing signs of dengue fever, especially thrombocytopenia, patients can go to Vinmec International General Hospital for examination and treatment. There is a team of well-trained and experienced infectious doctors, a system of complete and modern medical equipment and professional service quality for high efficiency in diagnosis and treatment. The hospital receives examination, diagnosis, treatment, cooperation against epidemics and takes care of patients with diseases caused by bacteria, parasites, infections with unknown causes. In particular, the Department of Infectious Diseases - Vinmec International General Hospital also includes the function of organizing vaccinations under the direction of the Ministry of Health, both for children and adults, in which special care is taken. Services for adults, typically vaccination against HPV virus, hepatitis A, hepatitis B, shingles, Herpes, malaria, pneumonia,...