Clinical profile and laboratory characteristics of dengue fever in children: analysis of 2019 outbreak from Bengaluru, Karnataka, India


  • Poornima Shankar Department of Pediatrics, KIMS Hospital and Research Centre, Bengaluru, Karnataka, India
  • Shajna Mahamud Department of Pediatrics, KIMS Hospital and Research Centre, Bengaluru, Karnataka, India



Dengue fever, Epidemic, Leukopenia, Thrombocytopenia


Background: Dengue, an endemic disease in most subtropical and tropical regions of the world is causing severe epidemics in India. An alarming rise of dengue has also been seen in India during the recent years. Majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. Present study was undertaken with an objective of describing various clinical presentations as noted in our cohort of dengue patients and to evaluate the outcome of dengue fever.

Methods: This retrospective study included all confirmed dengue cases below 18 years age admitted to Paediatric department of KIMS, Bengaluru over a period of 1 year in 2019. Medical records were reviewed and analysed. Those diagnosed to be positive for dengue serology (NS1 or IgM) were included in our study. Dengue was classified according to the WHO guidelines into 2 groups, Dengue fever (without/with warning signs) and Severe Dengue. Clinical features, haematological, biochemical, radiological parameters, management and the outcome were assessed.

Results: Out of 441 patients enrolled, 79% had non-severe dengue and 21% severe dengue. The commonest age of presentation was above 10 years with mean age of 8.68±5.25 years. Male to female ratio was 1.7:1. 60% presented within 4 to 7 days of illness (mean 4.26±1.72 days). Majority presented with fever (88%). 47% had vomiting and 31% abdominal pain. Bleeding manifestations were seen in 18%. Dengue serology was positive for NS1Ag (58%), IgM (21%), mixed (21%). Thrombocytopenia and leukopenia seen in 82% and 39.45% respectively. The association between dengue serology and platelet count was statistically significant (p value 0.001). 46% had raised SGPT. 31% had evidence of plasma leakage. The case fatality rate was 0.2%.

Conclusions: High grade fever, vomiting, abdominal pain and bleeding manifestations with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.


WHO. Small bite, big threat. WHO. Available at: Accessed on 23rd April 2019.

Chaudhuri M. What can India do about dengue fever? BMJ. 2013:346.

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.

National Guidelines for Clinical Management of Dengue Fever. Available at:

Gupta P, Khare V, Tripathi S, Nag VL, Kumar R, Khan MY et al. Assessment of WHO definition of dengue hemorrhagic fever in North India. J Infect Dev Ctries. 2010;4:150-5.

Kumaria R, Chakravarti A. Molecular detection and serotypic characterization of dengue viruses by single tube multiplex RT-PCR. Diagn Microbiol Infect Dis. 2005;52(4):311-6.

Chakravarti A, Kumaria R. Eco-epidemiological analysis of dengue infection during an outbreak of dengue fever, India. Virology J. 2005;2:32;1-7.

Endy TP, Nisalak A, Chunsuttiwat S, Libraty DH, Green S, Rothman AL et al. Spatial and temporal circulation of dengue virus serotypes: a prospective study of primary school children in Kamphaeng Phet, Thailand. Am J Epidemiol. 2002;56:52-9.

Graham RR, Juffrie M, Tan R, Hayes CG, Laksono I, Ma'Roef C, et al. A prospective sero epidemiologic study on dengue in children four to nine years of age in Yogyakarta, Indonesia Studies in 1995-1996. Am J Trop MedHyg 1999;61:412-19.

Kumar SK, Rajendran NK, Brabhukumar AC. Clinical profile of dengue fever in children: analysis of 2017 outbreak from central Kerala. Int J Contemp Pediatr. 2018;5:2265-9.

Neeraja M, Lakshmi V, Teja VD, Umabala P, Subbalakshmi MV. Serodiagnosis of dengue virus infection in patients presenting to a tertiary care hospital. Indian J Med Microbio. 2006;24(4):280.

Dash PK, Parida MM, Saxena P, Kumar M, Rai A, Pasha ST et al. Emergence and continued circulation of dengue-2 (genotype IV) virus strains in northern India. J Med Virol. 2004;74(2):314-22.

Ahmed S, Arif F, Yahya Y. 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(1):4-8.

Laul A, Laul P, Merugumala V, Pathak R, Miglani U, Saxena P. Clinical profiles of dengue infection during an outbreak in Northern India. J Tropical Med. 2016;2016.

Dhivya P, Monika A, Jayaramachandran S. Clinical profile of Dengue fever in an urban tertiary care hospital in South India. Int J Adv Med. 2019 Jun;6(3):618-22.

Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Develop Countr. 2012;6(07):551-4.

Singh N, Jhamb R, Agarwal S, Gaiha M, Dewan R, Daga M, et al. The 2003 outbreak of dengue fever in delhi, india. Southeast Asian J Trop Med Public Health. 2005;36(5):5.

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(8):705-6.

Shah I, Katira B. Clinical and laboratory abnormalities due to dengue in hospitalized children in Mumbai in 2004. Dengue Bulletin. 2005;29:90-6.

Mehra D, Taori K, Agrawal S, Sharma M. Clinical Profile of Dengue Fever. JMSCR. 2019;7(7):249-53.






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