Suočavanje s dengom: naše prvo iskustvo

  • Dejan Miroslav Cvjetković University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic for Infectious Disease, Novi Sad, Serbia.
  • Sandra Stefan Mikić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic for Infectious Disease, Novi Sad, Serbia.
  • Ivana B. Hrnjaković Cvjetković University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute of Public Health of Vojvodina, Center for Virology, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP151117247C
Ključne reči: dengue||, ||denga, diagnosis||, ||dijagnoza, signs and symptoms||, ||znaci i simptomi, leukopenia||, ||leukopenija, thrombocytopenia||, ||trombocitopenija, creatine kinase||, ||kreatin kinaza,

Sažetak


Uvod. Denga je oboljenje izazvano virusom denge, endemsko u tropskom i suptropskom pojasu. Autohtoni slučajevi retki su u Evropi. Oboljenje je najčešće uvezeno iz endemskih regija sveta. Prikazan je prvi slučaj denge koji je mikrobiološki potvrđen u Srbiji. Prikaz bolesnika. Po povratku s Kube, 34-godišnji muškarac se razboleo naglo, s febrilnošću, mialgijama, kožnim osipom, hepatosplenomegalijom, citopenijom, patološkim nalazima aminotransferaza i kreatin kinaze. Dijagnoza denge potvrđena je metodama virusološke dijagnostike. Značajna leukopenija i trombocitopenija bile su glavne karakteristike krvne slike. Laboratorijski znaci lezije jetre registrovani su tokom cele hospitalizacije. Aktivnost kreatin-kinaze u serumu bila je povišena na prijemu u bolnicu. Uz simptomatsko lečenje, bolest je imala povoljnu evoluciju, bez komplikacija. Bolesnik je otpušten iz bolnice afebrilan, bez tegoba, s diskretnim eritemom kože trupa i ruku. Vrednosti hematoloških parametara i kreatin kinaze na otpustu bile su uredne, a aktivnost alanin aminotransferaze umereno povišena. Zaključak. Zdravstvena služba naše zemlje trebalo bi da, u uslovima globalnih klimatskih promena i sve razvijenijeg međunarodnog transporta, bude spremna, u organizacionom, kadrovskom i materijalno-tehničkom pogledu, da odgovori na epidemijsku pojavu denge i drugih tropskih infektivnih bolesti u predstojećem periodu.

Biografije autora

Dejan Miroslav Cvjetković, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic for Infectious Disease, Novi Sad, Serbia.

Šef Odseka za herpes virusne infekcije i nejasna febrilna stanja

Vanredni profesor na Katedri za infektivne bolesti

Sandra Stefan Mikić, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic for Infectious Disease, Novi Sad, Serbia.

Načelnik Odeljenja za respiratorne infekcije i nejasna febrilna stanja

Vanredni profesor na Katedri za infektivne bolesti

Ivana B. Hrnjaković Cvjetković, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute of Public Health of Vojvodina, Center for Virology, Novi Sad, Serbia

Šef Odeljenja za kulturu ćelija i drugu virusološku dijagnostiku

Vanredni profesor na Katedri za mikrobiologiju

Reference

World Health Organization. Dengue and severe dengue. Fact sheet. 2015. May, N°117. [cited 2015 Oct 13]. Available from: http://www.who.int/mediacentre/factsheets/fs117/en/

European Centre for Disease Prevention and Control. Surveillance Report. Annual epidemiological report: Emerging and vector-borne diseases. Stockholm: ECDC; 2014.

Gjenero-Margan I, Aleraj B, Krajcar D, Lesnikar V, Klobučar A, Pem-Novosel I, et al. Autochthonous dengue fever in Croatia, August-September 2010. Euro Surveill 2011; 16(9): 19805.

Marchand E, Prat C, Jeannin C, Lafont E, Bergmann T, Flusin O, et al. Autochthonous case of dengue in France, October 2013. Euro Surveill 2013;18(50): 20661.

Wilder-Smith A, Quam M, Sessions O, Rocklov J, Liu-Helmersson J, Franco L, et al. The 2012 dengue outbreak in Madeira: Exploring the origins. Euro Surveill 2014; 19(8): 20718.

Durbin AP, Vargas MJ, Wanionek K, Hammond SN, Gordon A, Rocha C, et al. Phenotyping of peripheral blood mononuclear cells during acute dengue illness demonstrates infection and increased activation of monocytes in severe cases compared to classic dengue fever. Virology 2008; 376(2): 429−35.

Centers for Disease Control and Prevention. Laboratory Guidance and Diagnostic Testing. 2012. Sept 27. [cited 2015 Oct 13]. Available from: http://www.cdc.gov/Dengue/clinicalLab/laboratory.html

Saville M, Pitisuttithum P, Thisyakorn U, Bouckenooghe A, Yoon IK, van der Vliet D, et al. Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: A phase 3, randomised, observer-masked, placebo-controlled trial. Lancet 2014; 384(9951): 1358−65.

Thomas SJ, Endy TP, Rothman AL, Barrett AD. Flaviviruses. In: Mandel GL, Bennett JE, Dolin R, editors . Mandell, Douglass and Bennetts Principles and practice of infectious diseases. 8th. Philadelphia: Elsevier Saunders. 2015. p. 1881–1903.

Shepherd SM, Hinfey PB, Shoff WH. Dengue Fever. eMedicine January 2014. [cited 2015 October 13]. Available from: http://emedicine.medscape.com/article

Noisakran S, Onlamoon N, Hsiao H, Clark KB, Villinger F, Ansari AA, et al. Infection of bone marrow cells by dengue virus in vivo. Exp Hematol 2012; 40(3): 250−9.

Sargeant T, Harris T, Wilks R, Barned S, Galloway-Blake K, Ferguson T. Rhabdomyolysis and dengue fever: A case report and literature review. Case Rep Med 2013; 2013: 101058.

Oliveira EC, Pontes E, Cunha RV, Fròes IB, Nascimento Dd. Hematological abnormalities in patients with dengue. Rev Soc Bras Med Trop 2009; 42(6): 682−5. (Portuguesse)

Vilibić-Čavlek T, Ljubin-Sternak S, Babić-Erceg A, Svibon M, Mlinarić-Galinović G. Virology diagnosis of re-emergente infections: Dengue virus. Liječ Vjesn 2012; 134(5−6): 164−7.

Pem-Novosel I, Vilibic-Cavlek T, Gjenero-Margan I, Kaic B, Babic-Erceg A, Merdic E, et al. Dengue virus infection in Croatia: Seroprevalence and entomological study. New Microbiol 2015; 38(1): 97−100.

Borđoški M, Gligič A, Bošković R. Arbovirus infections in Serbia. Vojnosanit Pregl 1972; 29(4): 173−5. (Serbian)

Leshem E, Bin H, Shalom U, Perkin M, Schwartz E. Risk for emergence of dengue and chikungunya virus in Israel. Emerging Infect Dis 2012; 18(2): 345−7.

Objavljeno
2017/07/07
Broj časopisa
Vol. 74 Br. 6 (2017)
Rubrika
Prikaz bolesnika