The Importance of Early Diagnosis of Dengue for its Successful Treatment

Cardio MonitorThank you, Lord, our son is now recovering & we might already transfer to a regular room with a flat screen QHD TV tomorrow. This had been our TV set since yesterday when our doctor transferred my son to the pediatric ICU for closer monitoring. It only has one channel, but it beeps, and at least the display is colored. Hehe

Our experience this week shows the importance of early detection of dengue for its early and proper treatment. On the first day of his high fever, Ollie already brought our son to his pedia, Dr. Mary Johnson Cabaluna. However, since he also had symptoms of cough and cold, and also of asthma, he was just given medication for those conditions.

On the second day of his high fever, and suspecting that it could be dengue, Ollie called up Dr. Cabaluna to tell her about that our son had been manifesting symptoms of dengue fever. Dr. Cabaluna advised a Dengue NS1 Antigen Test. We immediately had him tested for NS1 Antigen and IgG and IgM. While IgG and IgM test was negative, the NS1 Antigen test was positive. We messaged the copy of the test results to Dr. Cabaluna & waited for her instructions. However, we learned that she still had class in the College of Medicine, and so we immediately called up several hospitals to check for available rooms & to make a reservation.

One should not wait for a CBC-platelet test for an indication of a decrease in platelet & white blood cells, and a high level of hematocrit in the blood. Those parameters would usually manifest themselves only on the 3rd to 4th day of having high fever and one may already be dehydrated by that time. Rapid tests are now available to determine the presence of the dengue virus in the body even on just the first day of having fever. These are the NS1 Antigen and IgG and IgM tests, also known as Dengue Duo Tests, where the results are known in less than an hour. With that, the proper treatment and management of the illness can immediately begin.

Hence, on the early evening of the 2nd day of his fever, we already brought our son to the hospital, and Dr. Cabaluna met us at the Emergency Room. There is yet no known medicine against dengue and it is, therefore, essential that one gets an essential supply of electrolytes and hydration thru IV to prevent dehydration during the febrile phase of the illness. That is very important to strengthen the body’s immune system so it can produce the necessary antibodies against the dengue virus.

Knowing that the nutrients you get from the IV are not really sufficient, we made sure that our son gets all the oral supplements he needed. Ollie would prepare fruit & vegetable juices for him, and I would squeeze fresh oranges. Fresh buko juice is also needed for electrolytes replacement. Balut soup also helps out in restoring blood platelets. Hi-calcium milk is also very important in addition to having plenty of mineral water. These are the survival juices he needed to boost his immune system, especially at a time when he still had no appetite for solid food.

On our fourth day in the hospital, and the first day of the critical phase of the illness, our son had been complaining of difficulty in breathing. An ECG test was immediately conducted and suspecting the possibility of myocardiatis or the inflammation of the heart muscles due to the viral infection, Dr. Cabaluna immediately transferred him to the pediatric ICU for closer monitoring. It is always best to be sure. She also ordered a Troponin Test to rule out the possibility of a heart attack. But thanks God, the Troponin Test was negative and myocardiatis has also been ruled out.

Patients who do not survive the critical phase of the illness, which is usually the 24 to 48 hours after the fever is gone, are those whose conditions are not diagnosed earlier and who, therefore, receive treatment late. To learn more about dengue, its diagnosis and treatment, please check out the Guidelines published by the World Health Organization (WHO) => http://www.who.int/…/publica…/documents/dengue-diagnosis.pdf and also the Guidelines published by the Department of Health (DOH) => http://www.doh.gov.ph/…/revised_%20dengue_clinical_manageme…

For our son’s treatment, we would like to thank the expertise and care provided by Dr. Mary Johnson Cabaluna, Dr. Rea Lara Asparin, and the resident physicians at the Bacolod Doctor’s Hospital. With their aggressive approach to the treatment of dengue, we did not reach the point where we have to prepare for standby blood. We also appreciate the care and smiles provided by the nurses and staff at Station 6 and Station 2 of the Doctor’s Hospital. We also thank all our relatives and friends for your concern and all the prayers you have offered. To God be the glory!

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