Overcoming Critical Dengue Shock Syndrome & Acute Liver Injury Through Precision Fluid & Blood-Component Care
01 Patient Presentation & Clinical Challenge
During peak monsoon transmission, 23-year-old university student Ms. Tasnim Jahan arrived with cold extremities, narrow pulse pressure (90/75 mmHg), rising hematocrit (51%), bilateral pleural effusion, platelet count of 9,000/µL, and acute dengue hepatic injury (SGPT 1,460 U/L).
02 Multidisciplinary Hospital Intervention
Admitted under senior Internal Medicine professor Prof. Dr. G K M Shahiduzzaman with co-management by Hepatology consultant Dr. Narwana Khaleque and the Critical Care team, strict WHO/National Dengue Guideline titration was instituted:
- Hourly hematocrit- and urine-output-guided isotonic crystalloid/colloid titration reversed shock while avoiding fluid overload in the lungs.
- 24/7 Transfusion Medicine & Blood Bank stood ready with screened platelet concentrates while hepatic protective therapy reversed transaminitis.
- Follow-up recovery was tracked seamlessly via DCIMCH’s Patient Portal and complimentary Report-Check OPD review.
03 Recovery Outcome & Follow-Up
By Day 5, plasma leakage resolved completely, platelets rose spontaneously past 95,000/µL, and liver enzymes dropped sharply. Tasnim returned to her university classes within two weeks in full health.
“Every two hours, doctors checked my hematocrit and adjusted my IV fluids drop by drop instead of rushing unnecessary transfusions. Their precision saved me during the most frightening week of my life.”