Dengue Geriatric Case Study Tropical Doctor
The article also examines the changes in weight that occur after diagnosis of dengue and compares it to weight loss (if any), that occurred prior to the diagnosis. Dealing with the anorexia and weight loss is challenging for physicians, patients and family members.
Keywords: dengue, geriatric, appetite, anorexia, weakness, absent fever Introduction: Dengue Is caused by the Dengue Virus (Eden-4), which Is a Fallacious (RNA), spread via the Aides Egypt mosquito. It Is prevalent In the tropical climate countries, as the environment Is Ideal for breeding mosquitoes.
Approximately 100 million people re affected by dengue yearly, making it the leading cause of illness and death worldwide Its effects range from asymptomatic to death due to fulminate shock and hemorrhage. Symptoms include sudden onset of fever, headache, retaliation pain, and back pain, along with severe malign giving rise to the colloquial designation “Break-bone fever”. Additional symptoms include anorexia, nausea or vomiting, marked coetaneous hypersensitivity and a muscular rash, starting at the trunk and spreading to the extremities of the face .
Fever being the prevalent symptom, dengue Is also often offered to as Dengue Fever.
In a review of dengue on the following websites – CDC. Gob, entitlement. Com, WebMD. Com, undersells. Com and Wakefield.
Com – anorexia is not listed as a symptom. It is presented as a mere footnote in Harridan’s Principle AT Internal Melamine Ana w prevention and control of dengue. Gleefulness Tort Lagoons, treatment, Since most clinicians are trained to recognize fever as the primary symptom, its absence may cause this entity to go undiagnosed.
The fact that anorexia was the main presenting complaint in our cohort of geriatric patients underscores the importance of this observation, since subsequent malnutrition and weight loss may complicate recovery. We present a collection of 10 cases seen at Mercy Clinic – NIH in Belize, Central America from August-September 2013. Cases: From August – September 2013, there was a spike in the number of Dengue cases seen at the clinic.
On average, around the rainy season, there is about 1 case per month. This year, over a six weeks period, there were 10 confirmed cases.
The two most common presenting symptoms, of the 10 patients, that triggered a testing for dengue were chief complaints of loss of appetite and/or feeling weak. Of the ten cases, only one presented with a chief complaint of fever, while another said he had chills, but the chief complaint was loss of appetite/weight. The cases review examined the following parameters: age, sex, weight at three, two and one month prior to diagnosis, at the time of diagnosis, and one month after (if available), symptoms – fever, rash, headaches, body aches, bleeding, loss of appetite and weakness, labs – Gig, IGMP, and CB.
Whether or not the patient was diabetic was also recorded. The average age of patients was 71. 9 years old. There were four male and six female patients. The two most common presenting symptoms that patients complained of were loss of appetite (8 out of 10) and weakness (9 out of 10). Conversely, only 2 of the 10 patients complained of fever; none complained of rash or bleeding; two complained of body ache, and one of a headache (Figure 1).
Figure 1 : Symptoms patients presented with at the time of diagnosis with dengue.
Patients taking glycoside were asked to suspend it if they were experiencing anorexia. They were told to resume medication once the anorexia subsided and a pre-dengue eating pattern was resumed. Unintentional weight loss and underproduction are common problems in the elderly. [5-8]To help treat the anorexia and weight loss, patients were advised to get a liquid dietary supplement such as Enjoy, Ensure or Glycerin, to help maintain a sufficient caloric intake and prevent weight loss.
Discussion: Although fever is the hallmark symptom of Dengue/Dengue Fever, testing for dengue In ten essence AT revere may De necessary Tort geriatric patients In enamels regions.
There is no dispute to the guidelines put forth by the World Health Organization, but an additional approach to diagnosing and treating geriatric patients with dengue should also be examined closely. A simple symptom like anorexia can wreak havoc for an elderly patient and their family. Further complications can develop if the tenant is on a medication that can lead to hypoglycemia.
An unintentional decline in weight is always a great cause for concern. While investigating for thyroid disorder, GIG anatomical issues, and cancer amongst many other causes of weight loss, having a positive dengue test, with no previous history of weight loss, can lead to the correlation that the weight loss is due to the dengue. A sudden decline in strength was also a very prevalent symptom.
While it is a subjective feeling that cannot be quantified, it is a very important piece of information. Patients are aware of what their normal energy and activity levels are, o a complaint of weakness is sufficient to warrant testing. Globally, the reported incidence of dengue has been increasing. Although climate may play a role in changing dengue incidence and distribution, it is but one of many factors; given its poor correlation with historical changes in incidence, its role may be minor. Other important factors potentially contributing to global changes in dengue incidence and distribution include population growth, arbitration, lack of sanitation, increased long-distance travel, ineffective mosquito control, and increased reporting capacity. ‘  Figure 5: WHO 2011 map of countries where dengue has been reported.
Conclusion: It is important for physicians to test for dengue if a geriatric patient, in an endemic region, presents with chief complaint(s) of anorexia and/or weakness in the absence of fever. Part of the treatment plan should include counseling on nutrition and liquid supplemental diets to help improve outcome and mitigate or even reverse any weight loss that may have occurred secondary to anorexia. Sometimes it is not the disease itself that causes the greatest concerns to the patients and health care providers, but ether what lies after.