Dengue: diagnosi, sintomi, terapia
Table of Contents
Che cos’è la febbre Dengue?
Ladengue è una malattia febbrile, causata dal virus della febbre rossa inoculato da una zanzara infetta del genere Aedes, caratterizzata da un inizio brusco concefalea, febbre, prostrazione, algie articolari e muscolari, leucopeniaed una eruzione orticarioide o morbilliforme sincrona alla ripresa della febbre.
Eziologia
L’agente patogeno è un arbovirus.Il virus è trasmesso all’uomo dalle zanzare; può essere messo in evidenza nel sangue dei malati dal giorno che precede la febbre fino al terzo-quarto giorno della malattia. L’immunità acquisita dalla febbre rossa, anche nella forma sintomatica, è di lunga durata per lo stesso tipo di virus ma è di breve durata per gli altri tipi.
Epidemiologia
Ladengueè endemica lungo le coste ed i fiumi, soprattutto in estate, nelle zone tropicali e sub- tropicali, in Africa, Asia, America del sud, Australia e nelle isole del Pacifico.
Quali sono i sintomi della dengue?
Dopo un’incubazione di 5-8 giorni compaiono:
- Febbre
- Cefalea
- Iniezione congiuntivale
- Nausea
- Vomito
- Atromialgie intense.
Nei giorni successivi si manifesta un esantema maculoso che inizia al tronco e poi si diffonde al resto del corpo, spesso con prurito palmo-plantare. In alcuni casi compaiono anche petecchie, ma l’evoluzione è solitamente favorevole, con risoluzione del quadro in una decina di giorni. Talora, tuttavia, la malattia evolve nella forma grave caratterizzata da segni di shock, petecchie e manifestazioni emorragiche. La mortalità può arrivare al 20% dei casi.
Leggi anche>Febbre bottonosa del Mediterraneo
Leggi anche>Febbre tifoide: cause, sintomi, trattamento
Diagnosi
È possibile isolare il virus nel sangue, ma oggi si ricorre più frequentemente alla ricerca della proteina NS1 e del genoma virale, mediante RT-PCR; è anche diagnosticata la presenza di IgM specifiche nella fase sintomatica. Gli esami ematici evidenziano inoltreleucopenia,piastrinopeniaeaumento delle transaminasi; nella forma grave, a causa dell’incrementata permeabilità capillare, è tipico l’aumento dell’ematocrito.
Terapia
Non esistono antivirali specifici. Nella forma grave emorragica, la terapia è volta a supportare le funzioni vitali. La profilassi si identifica con la lotta ai vettori.
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