Foster Developments Homeopathic

Medical College

Name – Dr. Yashwant Sudam

Chinchane
Class - MD Part 1
Department - Practice of Medicine
Topic – Dengue
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Unknown Author

Date - 4/7/2025
Under guidance - Dr Smita ma'am.
Learning objective
• What is dengue fever?
• Causative agent and mode of transmission?
• Pathogenesis
• Clinical feature
• Diagnostic test
• prevention
• Miasmatic background
• Prognosis
• Homoeopathic management
 INTRODUCTION
• Dengue fever is also known as breakbone fever.

• It is a arthropod-borne (arboviral) illness in human

it is caused by infection with 1 of the 4 serotypes of dengue
virus (denv 1, 2, 3, 4), which is flavivirus.

• Dengue is transmitted by the infective bite of aedes egypti

mosquito.
 ABSTRACT
Dengue is the most prevalent arthropod-borne virus
affecting humans today. The virus group consists of 4
serotypes that manifest with similar symptoms.
Dengue causes a spectrum of disease, ranging from a
mild febrile illness to a life-threatening dengue
haemorrhagic fever.
 WHAT IS DENGUE?
• Dengue is a viral disease.
• It is transmitted by the infective bite of aedes aegypti mosquito.
• Man develops disease after 5-6 days of bitten by an infective
mosquito
• lt occurs in two forms:
-Dengue fever
-Dengue Haemorrhagic lever (DHF)
• Dengue Fever is a severe, flu-like illness.
• Dengue haemorrhagic fever (DHF) is more severe form of disease,
which may cause death.
 DEFINITION

• Dengue is the mosquito-borne infection found

in tropical and sub- tropical regions around the world.
 GENERAL FACTS ABOUT DENGUE
• It is nicknamed break-bone fever.

• About 50-100 million infections world wide every year.

• Dengue fever is passed by infected female ADES

AEGYPTI mosquitoes.

• Dengue is caused by flaviviruses.

 CAUSATIVE AGENT OF DENGUE

° Dengue is cause by a RNA virus

° This virus is member of the viral family Flaviviridae
• Having 4 serotypes DENV-1, DENV-2, DENV-3 and DENV-4.
• All four serotypes can cause the full spectrum of diseases.
• Transmitted by aedes mosquitoes.
° Infection with one serotype is believed to produce lifelong
immunity to that serotype but only short term protection
against the others.
 TRANSMISSION

• Dengue is transmitted by several species of mosquito within the genus

Ades, principally A. aegypti.
• Humans are the primary host of the virus, but it circulates in non-
human primates.
• An infection can be acquired via single bite.
° A female mosquito that takes a blood meal from a person infected with
dengue fever becomes itself infected with the virus in the cells lining in
the gut.
° About 8-10 days later, the virus spreads to other tissues including the
mosquito ’s salivary gland and is subsequently released in to the saliva.
 MECHANISM

• When a mosquito carrying dengue virus bites a person,

the virus enters the skin together with the mosquito's saliva.
• It binds to and enters white blood cells and reproduces inside
the cells while they move throughout the body.
° In severe infection, the virus production inside the body is
greatly increased, and many more organs (such as the liver and
the bone marrow) can be affected, and the fluid from the blood
stream leaks through the wall of small blood vessels into body
cavities.
° As a result, less blood circulates in the blood vessels, and the
blood pressure becomes so low that it cannot supply sufficient
blood to vital organs.
° Furthermore, dysfunction of the bone marrow leads to
reduced numbers of platelets, which are necessary for
effective blood clotting; this increases the risk of bleeding, the
other major complication of dengue fever.
 SIGN AND SYMPTOMS

• Asymptomatic or mild such as an uncomplicated fever(80%)

• More severe illness (5%)

° In a small proportion it is life threatening

• The incubation period (time between exposure and onset of symptoms)

ranges from 3-14 days, but host often it is 4-7 days
• The characteristic symptoms of dengue are ‘-
1. Sudden onset fever
2. Headache (typically located behind the eyes)
3. Muscles and joint pain and a rash
4. The alternative name for dengue, “break-bone fever”
(comes from the associated muscle and joint pains)
• Symptoms include fever, headache,
muscles and joint pains and a
characteristic skin rash that is
similar to measles.
• In a small proportion of cases the
disease develops into the life-
threatening dengue
hemorrhagic fever.
• Resulting in bleeding, low levels
of blood platelets and blood
plasma leakage, or into dengue
shock syndrome, where
dangerously low blood
pressure occurs.
WARNING SIGNS

° Abdominal Pain
° Ongoing Vomiting
• Liver enlargement
• Mucosal bleeding
• High haematocrit with low
platelets
° Lethargy
• Vomiting with blood
• Swollen lymph nodes
The course of infection is divided into three
phases :-
Dengu@fever
1. Febrile phase
2. Critical phase
3. Recovery phase
 CRITICAL PHASE (last for 1 to 2 days)
• A critical phase, which follows the resolution of the high fever and
typically lasts for one to two days.
• During this phase there may be significant fluid accumulation in the chest
and abdominal cavity due to increased capillary permeability and leakage.
• This leads to depletion of fluid from circulation and decreased blood
supply to vital organs.
° Organs dysfunction and severe bleeding, typically from the GIT
• Shock (DHS) and haemorrhage (DHF) occurs in less than 5°é of all cases of
dengue.
• However those who have previously been infected with other
serotypes of dengue virus are at an increased risk.
 RECOVERY PHASE (last for 2 - 3 days)

•Resorption of leaked fluid into the blood stream.

•This is usually last two or three days
•Severe itching and a slow heart rate
° During this stage, a fluid overload state may
occurs; if affects the brain, it may cause a
reduced level of consciousness or seizures.
Dengue hemorrhagic fever (DHF)

It is a severe case of
dengue with hemorrhagic
tendency evidence by :-
• Positive tourniquet test
• Petechiae, ecchymosis or IH ' !! !' '

IxI• '
purpura
'
• Bleeding from mucosa
(epistaxis or bleeding from
gums), injection sites or
other sites ' ' ’ '’’'
 DENGUE SHOCK SYNDROME

All the above criteria of DHF plus

signs failure manifested by the
following:
• Rapid and weak pulse
• Narrow pulse pressure (</= to
20mm Hg)
• Hypotension for age
• Cold and clammy skin
• Restlessness
• Decreased or absent urine
 Associated problems with Dengue

• Dengue can occasionally affect several other body systems

• A decreased level of consciousness
• Infection of the brain by the virus or indirectly as a result of
impairment of vital organs, for example — Liver
• Other neurological disorders such as transverse myelitis and
Guillain-Barre Syndrome
• infection of the heart and acute liver failure are among the are
complications
 DIFFERENTIAL DIAGNOSIS

1. Chikungunya
2. Malaria
3. Leptospirosis
4. Typhoid fever
DIAGNOSTIC
TEST
Diagnosis is typically made clinically, in the basis
of
• Reported symptoms and physical examination
• Dengue rapid test
• Earliest change detectable on
Laboratory investigations:-
1) Low white blood cell count.
2) Increase plasma leakage results in
haemoconcentration(as indicated by a rising
haematocrit)
3) Hypoalbuminemia.
4) Pleural effusion or ascites can be detected
by physical examination when large.
5) Demonstration of fluid on USG may assist in the
early identification of dengue shock syndrome.
Complications
• Hyperpyrexia
• Severe haemorrhage
° Dengue Shock Syndrome
° Hematemesis
• Tachypnoea
• Bleeding gums
 Management

° Oral rehydration therapy

° Intravenous fluids
• Blood transfusion - PCV or Whole blood recommended
 Preventions
° There are approved vaccines for the dengue virus.
• Prevention thus depends on control of and protection from the bites
of the mosquito that transmits it.
• Aedes mosquitoes usually bite during the day.
Therefore, special precaution should be taken early morning hours
before day break and in the late afternoon before dark
• Conduct Dengue awareness programs in you areas
• Advice people showing symptoms of dengue to immediately go for
check-up is to find and eliminate their breeding sites.”
 Protection against mosquito

*Mosquito Net
*Screening - Screening of buildings with copper or bronze gauze
Repellents
* Stagnant water — The Aedes mosquito prefers to breed in clean, stagnant water. It is
important to frequently check and remove stagnant water in your home.
*Turn buckets and watering cans over - store them in shelter so water
cannot accumulate in them.
*Remove the water from plant pot plates- to remove mosquito eggs, clean
and scrub them completely.
 AIM OF TREATMENT

• Relieving symptoms of pain.

• Controlling fever.
• Telling patients to avoid aspirin and other nonsteroidal, anti-
inflammatory medications
• Drink more fluids, especially when they have a high fever. Oral
rehydration therapy
• Intravenous fluids
• Blood transfusion - PCV or Whole blood recommended.
🦟 Miasmatic Interpretation of Dengue Fever by Stage
1. Febrile Phase (Day 1–3) - High fever, headache, myalgia, rash, nausea
Psoric Psora is linked to hyper-reactivity, inflammation, and functional
disturbance. The body's intense response (fever, pain) reflects psoric
hypersensitivity.
2. Critical Phase (Day 3–6) - Plasma leakage, bleeding, low platelets,
hypotension. Syphilitic The destructive nature—hemorrhage, vascular
damage, shock—correlates with syphilitic miasm, known for tissue
breakdown and crisis states.
3. Recovery Phase (Day 6–10+) Reabsorption of fluids, weakness, slow
healing Sycotic / Psoric Sycotic miasm appears with slow convalescence,
residual swelling, or chronic immune overcompensation; psora may still
dominate as energy returns.
HOMEOPATHIC
REMEDIES
1. Eupatorium Perfoliatum for dengue fever with bone breaking

• This medicine is called ’ Bone Set’, since it relieves the

terrible deep bone pains with the Dengue fever
° Excruciating Pains in the muscles with high grade fever.
• Throbbing headache in the occiput and the vertex.
• Soreness in the eyes or the eyeballs.
• Chill preceded by intense thirst, severe soreness and aching in
bones
° Sweating provides relief except headache
2. Bryonia Alba— Homeopathic remedy for dengue fever with
intense thirst
• Stitching and tearing pains in the whole body with high grade fever,
• The two distinguishing features of this medicine are increased thirst
and that the pains and all sorts of sufferings of the patient are
aggravated motion.
•Dryness of the mouth, tongue and other mucous
membranes ,patient is thirsty for large quantities of water at one go.
• Severity of symptoms like intense headache at the temples ,
head brushing sensation, eye pain.
• Bitter taste in mouth.
3. Phosphorus — Homeopathic medicine for hemorrhagic dengue fever
• There is burning and numbness of the hands, arms and feet.
• Intense thirst with fever, the patient wants to have cold water
or even chilled water.
• Haemorrhage from any and every part or orifice of the body
may be seen.
• The patient may feel unusually hungry.
4. Rhus Tox — Homeopathic remedy for pains relieved by motion
• It is indicated by the muscular soreness and pains in the body which
are relieved only while in motion.
• The patient cannot rest as it is the worst position for him.
• The tongue gets coated white while the tip of the tongue remains
red and forms a red triangle at the tip.
• Severe aching of limbs and bones which is worse during rest and
better while moving around
• Extreme restlessness
5. Carica Papaya- homeopathic remedy for improving platelet count

• Carica Papaya is a homeopathic remedy made from papaya fruit.

• lt has been seen that it improves the platelet counts in patients whose
platelets are falling.
• Best for digestive system
° It is one of the best remedy metabolism of the body
° It increases the appetite
• Enlarged Liver and Spleen
6. Gelsemium- Homeopathic medicine for Dengue Fever with
weakness and prostration
•A state of dullness, dizziness and drowsiness is the perfect
description to select Gelsemium.
• The patients seem lethargic and have a desire to lie down in perfect
silence without any disturbance.
•The patient experiences chill during fever in the back and travels
up and down the back.
• Occipital Headache travelling to forehead and eyes.
• There is also an absence of thirst ‹n majority of cases.
 PROGNOSIS
• Usually with regular treatment and ample rest
and fluids the prognosis is good
• But in some cases Dengue can turn Hemorrhagic
due to low platelet count which can be life
threatening
• Regular monitoring of patient is important
 CONCLUSION
• Though Dengue fever has various clinical manifestations
none were specific to the disease.
• Fever was the only clinical feature which was maximally
associated.
• Total leucocyte count may determine the outcome
• More prospective study and more number of cases are to
be analyzed to know the exact clinical manifestation which
may determine the outcome.
• Homeopathy plays a great role ¡n managing DENGUE