Serum sodium as a prognostic marker in dengue fever cases admitted to PICU in Navodaya hospital, Raichur, India

A. Akshay Reddy, T. Prashanth Reddy, Pranam G. M., Usha Pranam, G. A. Manjunath


Background: Dengue fever is an arboviral infection which is mosquito transmitted, most common in tropical and subtropical countries. Worldwide around 2.5 billion population are at the risk of developing dengue infection.

Methods: The study was carried out in a 5 bedded (high dependency unit) PICU of Navodaya Medical College and Hospital, Raichur, Karnataka, India. The study was approved by the ethical committee of the hospital. The study was performed over a period of 12 months from August 2015 - August 2016. The study group included individuals from the age group of 1 month to 18 years, who were diagnosed with dengue fever.

Results: Out of the total 99 cases, 36 cases had no variation in serum sodium levels, 33 cases were mild hyponatremic, 12 cases were moderate hyponatremic and 18 cases were severely hyponatremic. Out of the 36 cases with normal serum sodium levels, only 1 case progressed to bleeding complications. Out of the 33 cases with mild serum sodium levels, 2 cases progressed to complications out of which 1 case having bleeding manifestations and 1 case having both bleeding and central nervous system (CNS) complications.

Conclusions: Hyponatremia is the most common electrolyte disturbance in dengue fever as well as dengue associated complications. The lower the serum sodium levels the higher is the incidence of complications associated with dengue fever. The incidence of CNS and bleeding complications is more as compared to the RS and hepatobiliary complications. The incidence of RS and hepatobiliary complications is high with moderate and severe hyponatremia. Thus serum sodium plays a most important role in the prognosis of dengue fever and associated complications.


Dengue fever, Dengue associated complications, Hyponatremia

Full Text:



World health organization (WHO). Dengue / dengue hemorrhagic fever. Geneva : WHO;2009.

Tomashek KM, Sharp TM, Margolis HS, Geme SS. Dengue 2016 yellow book/travellers’ health/CDC. Nelson Textbook of Paediatrics. 20th edition. Elsevier; 2016:1629.

Varavithya W, Manu P. Studies on dengue hemorrhagic fever II: Electrolyte study. Journal Med Asso. 1973;56:15-23.

Mekmullica J, Suwanphatra A. Serum and urine Sodium levels in Dengue levels; South East Asian J Trop Med Public Health. 2005;36(1):197-9.

Lumpapong P, Wplong K, Watana V, Thira JP. Electrolyte disturbances and abnormal urine analysis in children with dengue infection. South East Asian J Trop Med Public Health. 2010;41(1):72-6.

Olsen KM, Peddicord TE, Campbell DG, Rupp ME. Antimicrobial effects of lidocaine in bronchoalveolar lavage fluid. J Antimicrobial Chemotheraphy. 2000;45(2):217-9.

Gadkari DA, Shaik BH. IgM antibody capture elisa in the diagnosis of Japanese encephalitis. West Nile & dengue virus infections. Indian J Med Res. 1984;80:613-9.

Schoenfeld R. Electrolyte disturbances in dengue infected patients. Int J Research Health Sci. Clin Chem. 1964;10:533.

Ranjit S. Manual of paediatric emergencies and critical care. Paras Medical Publisher, Hyderabad. New Delhi, India: 337.

Patel S. Sodium balance an integrated physiological model and novel approach. Saudi J Kidney Dis Transplantation. 2009;20(4):560-56.

Sn B, Br SP, Ra TD. Electrolye disturbance in dengue infected patients: a hospital based study. Int J Res Health Sci Internet. 2015;3(1):130-3.