KOLKATA: A persisting fever, fluid accumulation and breathing distress have been the distinguishing features of dengue this season, according to a section of doctors. These have also been the signs of the disease taking a severe form this time. A significant number of patients with these symptoms have suffered a platelet drop, capillary leak and coagulopathy which are the most dangerous of dengue impacts, they said.
Even as the number of patients continues to rise across hospitals, the count of those with a severe disease has also been swelling. While dengue fever rarely lasts beyond three-four days, a sizeable section is now admitted with high temperature that hasn't subsided for more than a week. Some of them have stomach pain and breathing distress which have accentuated their discomfort and could be due to the fact that they are 'repeat' patients or have been infected a second time which makes the infection more potent, said AMRI Hospitals infectious diseases physician Sayan Chakraborty.
"Several have a continuing fever which keeps recurring along with other symptoms that can get severe. Many are suffering a platelet drop or a capillary leak. The latter group requires proper liquid intake. Excessive liquid infusion, too, could be risky," said Chakraborty.
He added that the fever pattern has been different during this outbreak. "Despite medication, a low temperature has been continuing which indicates a severe disease. Platelet drop and coagulopathy (inability of the system to form blood clots), too, have been common among this group which remains vulnerable," he said.
Fever could be prolonged due to hyper-immune reaction while fluid accumulation may lead to stomach pain, according to RN Tagore International Institute of Cardiac Sciences (RTIICS) intensivist Sauren Panja. "These indicate a severe disease. These patients also prone to secondary bacterial infection due to low immunity," said Panja.
Capillary leak occurs when plasma oozes of tiny blood vessels and gets into muscles, tissues, organs and body cavities. Capillary leak could also be triggered by upper respiratory tract infection.
Medica Superspecialty Hospital has 38 dengue patients admitted, seven of whom are in critical care. "Many are experiencing HLH or Hemophagocytic Lymphohistiocytosis, an immunological condition that prolongs fever beyond five to seven days, leads to a drop in blood count and also contributes to liver-related and other late complications," said Tanmay Banerjee, director of the Medica Institute of Critical Care.
At AMRI Hospitals, number of patients across its three units has swelled to 71 from 62 last week. Seven are in ICU.
Woodlands Hospital has seen a marginal rise in dengue admissions from 13 to 16 in last seven days said Rupali Basu, MD & CEO of Woodlands Multispeciality Hospital.

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