Clinical profile and outcome of dengue fever in hospitalized children of South Rajasthan, India
DOI:
https://doi.org/10.18203/2349-3291.ijcp20161035Keywords:
Child, Dengue, Revised classification, Warning signs, WHOAbstract
Background: Dengue fever is rising globally and also in India. Dengue can present with varied clinical manifestations. The mortality rate can be reduced by timely diagnosis, strict monitoring and proper fluid resuscitation.
Methods: In this study children with positive dengue rapid test in the age group of 0-15 years were included. All cases were classified as WHO new case classification guideline and detailed clinical profile were recorded in proforma.
Results: Out of 65 cases, males were 53% and females were 47% with maximum number of cases seen in the age group of 5-10 years (46%). We reported children with dengue without warning signs (23%), dengue with warning signs (64%), and severe dengue (12%) of cases. Fever was observed in all cases. Myalgia and headache was most common symptom followed by mucosal bleed. Hepatomegaly was observed in 90% of cases. Only one case had central nervous system involvement. Lab parameters include raised hematocrit (84%), thrombocytopenia (80%) and leucopenia (44%). Crystalloids were used in (76%). Colloids were not used. Blood products were required in 5 cases. No mortality was observed in our study.
Conclusions: Children in the age group of 5-10 years were most commonly affected. Early diagnosis with rapid test, dengue case classification by revised WHO guideline, strict monitoring, appropriate fluid management and judicious use of blood product have yielded a fruitful outcome.
References
Dengue/dengue haemorrhagic fever. Wkly Epidemiol Rec. 2000;75:193-6.
Cho-Min-Naing. Assessment of dengue hemorrhagic fever in Myanmar. Southeast Asian J Trop Med Public Health. 2000;31:636-41.
Choudhury J, Shastri DD. Diagnosis and management of dengue in children: Recommendations and IAP ID chapter plan of action. Pediatr Infect Dis. 2014;1;6:54-62.
Nimmannity S. Clinical manifestation of Dengue/DHF. In: Monograph on Dengue/DHF. New Delhi; WHO Regional Publication. SEARO22. 1993:48-54.
Alexander N, Balmaseda A, Coelho IC, Dimaano E, Hien TT, Hung NT. Multicentre prospective study on dengue classification in four South-east Asian and three Latin American countries. Trop Med Int Health. 2011;16:936-48.
WHO: Dengue Guildelines for Diagnosis, Prevention and Control. New edition. Geneva, Switzerland: World Health Organisation. 2009.
WHO: Handbook for Clinical Management of Dengue. 2012.
Barniol J, Gaczkowski R, Barbato EV, da Cunha RV, Salgado D, Martínez E. Usefulness and applicability of the revised dengue case classification by disease: multi-centre study in 18 countries. BMC Infect Dis. 2011;11:106.
Mittal H, Faridi MM, Arora SK, Patil R. Clinicohematological profile and platelet trends in children with dengue during 2010 epidemic in north India. Indian J Pediatr. 2012;79:467-71.
Sahana KS, Sujatha R. Clinical profile of dengue among children according to revised WHO classification: analysis of a 2012 outbreak from Southern India. Indian J Pediatr 2015;82:109-13.
Ratageri VH, Shepur TA, Wari PK, Chavan SC, Mujahid IB, Yergolkar PN. Clinical profile and outcome of Dengue fever cases. Indian J Pediatr. 2005;72:705-6.
Bethell DB, Gamble J, Pham PL, Nguyen MD, Tran TH, Ha TH. Noninvasive measurement of microvascular leakage in patients with dengue hemorrhagic fever. Clin Infect Dis. 2001;32:243-53.
Narayanan M, Aravind MA, Thilothammal N, Prema R, Sargunam CS, Ramamurty N. Dengue fever epidemic in Chennai - a study of clinical profile and outcome. Indian Pediatr. 2002;39:1027-33.
Ahmed S, Arif F, Yahya Y, Rehman A, Abbas K, Ashraf S. Dengue fever outbreak in Karachi 2006 – a study of profile and outcome of children under 15 years of age. J Pak Med Assoc. 2008;58:4-8.
Jackson ST, Mullings A, Bennett F, Khan C, Gordon-Strachan G, Rhoden T. Dengue infection in patients presenting with neurological manifestations in a dengue endemic population. West Indian Med J. 2008;57:373-6.
Jagadishkumar K, Jain P, Manjunath VG, Umesh L.
Hepatic involvement in dengue Fever in children. Iran J Pediatr. 2012;22:231-6.
Colbert JA, Gordon A, Roxelin R, Silva S, Silva J, Rocha C. Ultrasound measurement of gallbladder wall thickening as a diagnostic test and prognostic indicator for severe dengue in pediatric patients. Pediatr Infect Dis J. 2007;26:850-2.
Kumarasamy V, Wahab AH, Chua SK, Hassan Z, Chem YK, Mohamad M. Evaluation of a commercial dengue NS1 antigen-capture ELISA for laboratory diagnosis of acute dengue virus infection. J Virol Methods. 2007;140:75-9.
