Complications of dengue are due to immunological reactions like COVID 19 virus. Although clinical manifestations vary in different viruses, almost all complications can be prevented by early use of glucocorticoids preferably prednisolone. During last three weeks we have used prednisolone 40 mg daily within 2 to 4 days of onset of fever in NS1 four positive adult cases of dengue with high fever and three child cases NS1 negative ( 102 to 106 degree Fahrenheit ) in Dhaka and Rangpur, Bangladesh. Surprisingly, in all cases, fever subsided to base line within 6 to 7hours with a single dose of prednisolone. Platelets counts found normal till three weeks of followup. There was no loss of appetite but blood pressure found reduced for several days. It is easy to prove by prescribing it(40mg prednisolone) along with famotidine 40mg and wait for 6 hours.
At this time ( Sept,2023) Dengue crisis is appearing worsen in Dhaka , Capital of Bangladesh. Patients are being treated by paracetamol only but high fever not responding, rather complications are encouragingly increasing. I believe, complications are due to cytokines or other chemical mediators released immunologicaly, attached to the target cells or tissue. I think, the half life of these chemical mediators is short and as soon as steroid starts acting against inflammation, the temperature rapidly subsided. As viremia in dengue may persist for several days steroid should be continued till the chance of inflammation. Rapid remission of temperature with a single dose of prednisolone within 6 to 8 hours is a miracle, though cause of this action is a matter of much investigation. However the information should be rapidly disseminated among the medical professionals for the benefit of the vulnerable patients.
- Badges
- Science topic