Cidades como Vitória da Conquista, Guanambi e Brumado estão entre as mais afetadas com aumento de casos da doença
Por UniFG/ Via ComunicAtiva
14 cidades baianas vivem uma epidemia de Dengue neste verão. De acordo com dados da Secretaria da Saúde do Estado da Bahia (Sesab), o Sudoeste é uma das regiões do estado que mais registra casos da arbovirose, incluindo municípios como Guanambi, Brumado e Vitória da Conquista. Segundo especialistas, as condições climáticas desta época do ano contribuem para o aumento dos casos.
Tal cenário tem mobilizado as secretarias de Saúde e população para cuidados preventivos de combate a propagação do mosquito Aedes aegypti, transmissor da doença. Mas como identificar os primeiros sintomas da Dengue? Quando é necessário buscar atendimento médico? Quais medicamentos devem ser evitados em caso de suspeita da doença?
De acordo com o médico especialista em Medicina Interna e Gastroenterologia e mestre em Saúde Tropical, Irineu dos Santos Viana, a Dengue pode ser assintomática ou apresentar-se como uma doença febril leve e autolimitada, sendo a segunda a sua apresentação mais comum. “Os sintomas da Dengue são inespecíficos, assemelhando-se a outras viroses e incluem febre, dor de cabeça, dores musculares e articulares, dor retro orbitária (região atrás dos olhos), fadiga, erupções cutâneas, náuseas e vômitos”, explica o médico, que também é professor e coordenador do curso de Medicina da UniFG, campus Brumado, parte integrante da Inspirali, melhor ecossistema de educação em saúde do país.
Viana destaca, contudo, que uma minoria dos casos pode evoluir para uma forma grave, com possibilidade de levar ao óbito por choque hipovolêmico, insuficiência respiratória, hemorragias (Dengue Hemorrágica) e comprometimento de órgãos como miocardite, hepatite, colecistite ou pancreatite.
“Os sinais de alerta que indicam uma maior gravidade da doença são dor ou desconforto abdominal, vômitos persistentes, sangramentos de mucosas, edemas, sonolência, letargia ou irritabilidade, hepatomegalia (aumento do fígado) e hemograma revelando aumento do hematócrito e diminuição da contagem de plaquetas”, chama a atenção o professor.
Mas quando é necessário buscar um atendimento médico? Segundo Irineu, a população precisa buscar atendimento, inicialmente ambulatorial, caso apresente sintomas. “É necessário para que o paciente seja avaliado e classificado quanto à forma da sua doença, com orientações para reconhecimento precoce dos sinais de alerta, momento em que deverá retornar à unidade de saúde. Deverão ser hospitalizados aqueles com doença grave, que evoluem com sinais de alerta, os que tem outras comorbidades e os pacientes incapazes de se manterem hidratados com ingestão oral”, esclarece.
O professor ressalta, ainda, que em casos de suspeita de Dengue alguns medicamentos precisam ser evitados. “O uso de anti-inflamatórios não esteroidais como o ácido acetilsalicílico (AAS/Aspirina) e outros, como o Ibuprofeno, deve ser evitado, pois agem na agregação plaquetária, interferindo na coagulação sanguínea, podendo precipitar hemorragias e a forma grave da doença”, alerta.
Dengue X Covid-19
Paralelamente a epidemia de Dengue em muitas regiões brasileiras, um aumento de casos de Covid-19 também foi identificado em algumas regiões após as festividades de final de ano e período de férias.
Ambas as doenças, de etiologias virais, possuem sintomas semelhantes e inespecíficos, muitas vezes dificultando o diagnóstico clínico. De acordo com Irineu Viana, uma das diferenças marcantes que pode ajudar no diagnóstico diferencial é o comprometimento inicial do trato respiratório, incomum na Dengue e frequente na Covid-19, como tosse, falta de ar e dor de garganta. Além disso, a perda de olfato e/ou do paladar pode ocorrer na Covid-19 e as erupções cutâneas, quando ocorrem, são mais comuns na Dengue.
“Vale salientar que, embora raro, existe a possibilidade da coinfecção, ou seja, o diagnóstico simultâneo das duas doenças. Exames complementares, como hemograma, prova do laço, pesquisa de antígenos virais, sorologias, PCR e isolamento viral por cultura celular podem ajudar no diagnóstico definitivo”, explica o médico.
Tratamento
Os cuidados se baseiam no alívio dos sintomas, com repouso, hidratação adequada, medicamentos para controle da dor e da febre, a exemplo do Paracetamol, e monitoramento médico rigoroso para detectar sinais de maior gravidade. Segundo Viana, nos casos de suspeita de gravidade, o internamento hospitalar é essencial para hidratação intravenosa; transfusão de hemoderivados (concentrado de hemácias e plaquetas) quando necessária; e cuidados intensivos, com suporte ventilatório, em casos de insuficiência respiratória.
“É importante destacar que as condutas devem ser individualizadas, e a avaliação médica é fundamental para uma melhor orientação e evitar possíveis complicações da doença. Tão importante quanto o tratamento são as medidas de prevenção, visando reduzir a proliferação do Aedes aegypti e proteger as pessoas da picada deste mosquito”, finaliza o professor da UniFG/inspirali.
Foto: Divulgação
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