Clinical profile of dengue fever in children presented at a tertiary care hospital

Authors

  • Senthilkumar K. M. Department of Pediatrics, Government Medical College and Hospital, Pudukottai, Tamil Nadu, India
  • Hema Harini R. Department of Pediatrics, Government Medical College and Hospital, Pudukottai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20190726

Keywords:

Bleeding tendencies, Dengue haemorrhagic fever, Dengue shock syndrome, Increased capillary permeability, Thrombocytopenia

Abstract

Background: Dengue fever is a benign syndrome caused by an arthropod-borne virus and is characterized by Biphasic fever, myalgia, and arthralgia, rash, leucopenia, and lymphadenopathy. Dengue hemorrhagic fever and dengue shock syndrome are a severe, often fatal febrile disease caused by 1 of 4 dengue virus. It is characterized by increased capillary permeability, abnormalities of hemostasis and protein-losing shock syndrome. The aim of this study was to assess the clinical profile, complications and outcome of dengue infection in children.

Methods: All children attending the hospital with symptoms and signs suggestive of dengue fever were tested for NS1 antigen and IgM/ IgG dengue antibody serology (depending on the day of fever) by enzyme-linked immunosorbent assay (ELISA) technique.

Results: Of the 174-dengue serology positive children, fever was the most common major symptom (97.7%) followed by vomiting (85.6%), loss of appetite (81.6%), abdominal pain (77%), body pain/leg pain (62.6%). Severe dengue as per WHO criteria was seen in 29 (16.7%) children. Thrombocytopenia (platelet count less 1,00,000) was observed in 82 children (47%), Platelet count less than 20,000 in 8 children (4.5%). Dengue shock syndrome was seen it 26 children (15%). Mortality was nil.

Conclusions: In children, if symptoms like fever, vomiting, loss of appetite, abdominal pain and body pain are present, a strong possibility of dengue fever is present especially in an epidemic setting. Early suspicion and effective management can reduce the severity.

References

Scott B. eds. Halstead, Nelson textbook of Pediatrics, 20th Ed :1629-1632.

World Health Organization. (‎2009)‎. Dengue guidelines for diagnosis, treatment, prevention and control: new edition. Geneva: World Health Organization. Available at: http://www.who.int/iris/handle/10665/44188.

Sahaana C, Mishra A, Bazroy J. Trend of morbidity and mortality of dengue in Tamil Nadu and Puducherry, South India. Int J Community Med Public Health. 2017;5(1):322.

India M. Dengue: National Vector Borne Disease Control Programme (NVBDCP). Nvbdcp.gov.in. 2018. Available at: http://www.nvbdcp.gov.in/index1.php?lang=1&level=1&sublinkid=5776&lid=3690

Dengue and severe dengue. WHO.int. 2018. Available at: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue.

Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, et al. The global distribution and burden of dengue. Nature. 2013;496(7446):504-7.

Endy TP, Anderson KB, Nisalak A, Yoon IK, Green S, Rothman AL, et al. Determinants of inapparent and symptomatic dengue infection in a prospective study of primary school children in Kamphaeng Phet, Thailand. PLoS Negl Trop Dis. 2011;5(3):e975.

Hung NT, Lei HY, Lan NT, Lin YS, Huang KJ, Lien LB, et al. Dengue hemorrhagic fever in infants: a study of clinical and cytokine profiles. J Infect Dis. 2004 15;189(2):221-32.

Deen JL, Harris E, Wills B, Balmaseda A, Hammond SN, Rocha C, et al. The WHO dengue classification and case definitions: time for a reassessment. Lancet. 2006;368(9530):170-3.

Selvan T, Nagaraj MV, Saravanan P, Somashekar. A study of clinical profile of dengue fever in children. Int J Contemporary Pediatr. 2017;4(2):534-7.

Mishra S, Ramanathan R, Agarwalla S. Clinical Profile of Dengue Fever in Children: A Study from Southern Odisha, India. Scientifica. 2016;2016:1-6.

Deshwal R, Qureshi I, Singh R. Clinical and Laboratory Profile of Dengue Fever. J Asso Physicians India. 2015;63:30-2.

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Published

2019-02-23

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Original Research Articles