We’ve been away for a while and if you’ve been following us on Facebook, you might have read about Hercules being in hospital for dengue – yes it was confirmed to be dengue.
Our trauma started last Sunday night when Hercules started heating up. I took him to the doctor on Monday morning and he was diagnosed with an infection that caused swelling and white spots on his tonsils. The doctor prescribed him a course of antibiotics and some fever medication. Aside from a very clinging and cranky toddler, all went well and the fever came down on Thursday morning. Hercules was in relatively good spirits so I thought all was clear.
As I changed him that morning, I noticed spots on his hands and feet. They gave his skin a generalised blotchiness:
Since children commonly develop a rash after a viral infection, I was not too concerned. After all, Hercules was eating and drinking and running around much like his usual self. I decided to take him to the doctor anyway just to confirm that all was fine.
The doctor was more suspicious so he did an in-office dengue test that took about 15 minutes. The test result was faint but present so we were advised to take Hercules to the hospital for further testing and monitoring. Our routine check-up had taken a turn for the worse as I had originally anticipated that we would confirm that the rash was nothing to be worried about and then I would pick up Aristotle from school. Instead, we ended up at the hospital where Hercules underwent further blood testing which he protested against most vehemently.
Both doctors and nurses were surprised because Hercules looked so “well”. Aside from a somewhat depressed appetite (still eating but less than his usual), he was still running around and climbing the play structures. Based on how well my son appeared, I felt certain the second test would prove the first was a false positive test result. It was not. The second test revealed the presence of the dengue virus in his blood although his platelet count was still within the normal range (albeit on the low side). There was no viral antigen which indicated that the infection was in its early stages. That meant that Hercules had to stay in hospital for further monitoring
What he had was originally tonsilitis and subsequently dengue. Although the tonsilitis was not of concern (he just had to finish the course of antibiotics he started), the dengue had to be monitored. He had no fever but they had to make sure the fever was gone for at least 48 hours before he could be released. They also had to keep tabs on his platelets to make sure it wasn’t dropping. According to the doctor, it usually got worse from this stage.
Hercules stayed fever-free throughout his stay at the hospital but because his fluid intake was insufficient, the doctor ordered a drip. I think the most traumatic part of the stay at the hospital was the IV line in his hand:
I’ve never heard my tough little boy cry so much and it broke my heart to have to hold him down while they inserted the IV line. The whole experience taught me a lot about how Hercules handles pain. Although he cried a lot, towards the end, he just shut his eyes and bore it stoically. I found that the less consolation I offered him, the easier it was for him. All I had to do was be there for him physically (to stroke his hair, or his face, or his arm) and he would calm himself down. If I tried to offer solutions, he would cry even more. At the end, he would still complain that his hand hurt, but I think what bothered him was the fact that his hand was plastered up rather than the fact that it hurt.
On the second day, something went wrong with the drip and his hand started to swell. He woke up from a nap complaining about his hand. I noticed it was swollen so I called the nurse who then removed the IV line. Unfortunately, they weren’t done with the IV so he had to have another line put back into his other hand the next morning. This experience was enough for Hercules to decide that he thoroughly hates doctors now. He was a little more forgiving with the nurses and was willing to say “goodbye” to them after he was discharged, although he would give them the evil eye whenever they came into his room.
The second blood test revealed a slightly lower platelet count (but still within normal range) but since his fluid intake had improved and the fever stayed away, he was allowed to go home. We still need to monitor him but it looks good. The danger with dengue is when the platelet count drops too low and the patient starts to bleed. There is also concern regarding dehydration. So as long as his fever does not return for more than 48 hours, he doesn’t start bleeding from the gums and nose (more than once), he should be fine. He will have to get a final blood test on Monday to make sure that his platelets remain stable.
A Little Bit About Dengue
Dengue is a viral infection that is transmitted by a type of mosquito called the Aedes mosquito. In order to contract dengue, you must be bitten by an Aedes mosquito that is carrying the dengue virus. There are four different strains of dengue. Once you contract dengue, you will develop immunity to that particular strain for life. Unfortunately, you will still be susceptible to the other three strains.
Since dengue is a viral illness there is no treatment for it. Dengue management usually involves monitoring of the symptoms and treatment of the symptoms. Although there are other symptoms associated with dengue, there are are three things to watch out for:
Because of the latter two, hospitalisation is usually required. Dehydration (if the patient is unable to sufficiently replenish lost fluids orally) can be treated with an IV drip. Bleeding is usually the result of a depressed platelet count. Platelet level is monitored in hospital via regular blood tests. If the platelet count drops too low, blood replacement may be necessary to control the bleeding. Because of this, the use of aspirin and other NSAIDs (non-steroidal anti-inflammatories) should also be avoided as they can worsen the bleeding. The concern for children below 10 years is dengue haemorrhagic fever which is potentially deadly. I supposed that’s why the doctor was so cautious with Hercules.
Patients are usually discharged from hospital once their blood tests show their platelet count on an increasing trend and when they have been fever-free for 48 hours.
Hospital policy meant that Aristotle was not allowed to visit Hercules in hospital. Aristotle was so upset that he carried his brother’s photo around with him everywhere he went. Despite the fact that the boys fight a lot when they are together, Aristotle was distraught by the news that his brother had to stay in hospital. It melted my heart to witness how much Aristotle loves his brother.
We are thankful to everyone who sent us their well-wishes and positive thoughts so that Hercules could recover quickly and be home again. I really believe it helped to have all that positive energy directed at Hercules. Thank you.