Clinical profile and outcome of dengue fever among children in tertiary care hospital
Keywords:Dengue fever, Dengue hemorrhagic fever, Dengue shock syndrome
Background: Dengue viral infection is the most common mosquito-borne disease in the world with varied presentations, high morbidity, and high mortality patterns. To study the clinical profile and outcome of dengue fever in children.
Methods: This analytical study was conducted in children less than 12 years of age with clinical features of dengue (any acute febrile illness with one of the following: myalgia, headache, retro-orbital pain, bleeding, altered sensorium, shock, or low platelet count) presented at Mahavir institute of medical sciences between February 2019 to January 2020 (12) months were included in the study. Children positive for IgM alone or both IgM and IgG were followed up for a clinical profile.
Results: Seizures (9.5%), loose stools (8.5%), lymphadenopathy (15.2%), relative bradycardia (8.5%) were less common manifestations. Rashes were seen in 64.7% of children. Many children in this study were mildly anemic. Mean hemoglobin was slightly higher in dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Mean Hb in DSS was 11.28 g%. It was 10.02, 10.1, and 10.45 in DF, DFB, DHF respectively. But it was statistically not significant (P=0.27).
Conclusions: Seizure was significant in DSS cases. Any dengue child throwing convulsions should hence be promptly evaluated for an unrecognized shock. The bleeding in dengue is not purely due to thrombocytopenia. There is no role for prophylactic platelet transfusion.
Agarwal R, Kapoor S. A clinical study of the patients with dengue hemorrhagic fever during the epidemic at Lucknow, India. Southeast Asian J Trop Med Pub Heal. 1999;30:735–40.
Anonymous. Dengue in the WHO Western Pacific Region. Week Epidemiolog Rec 1998;72:273–80.
Cardosa MJ, Wang SM, Sum MS, Tio PH. Antibodies against prM protein distinguish between previous infection with dengue and Japanese encephalitis viruses. Bio Med Cent Microbiol. 2002;2(1):1-6.
Chareonsook O, Foy HM, Teeraratkul A. Changing epidemiology of dengue hemorrhagic fever in Thailand. Epidemiol Infect 1999;122:161–6.
De Paula SO, Pires Neto RJ, Correa JA, et al. The use of reverse transcription-polymerase chain reaction (RT-PCR) for the rapid detection and identification of dengue virus in an endemic region: a validation study. Trans R Soc Trop Med Hyg 2002;96:266–9.
Guzmán MG, Kouri GP, Bravo J, Soler M, Vazquez S, Morier L. Dengue hemorrhagic fever in Cuba, 1981: a retrospective seroepidemiologic study. The Am J Tropic Med Hyg. 1990;42(2):179-84.
Ha DQ, Tien NT, Huong VT, Loan HT, Thang CM. Dengue epidemic in southern Vietnam, 1998. Emerg Infect Diseas. 2000;6(4):422.
Halstead SB, Lan NT, Myint TT, Shwe TN, Nisalak A, Kalyanarooj S, et al. Dengue hemorrhagic fever in infants: research opportunities ignored. Emerg Infect Disea. 2002;8(12):1474.
Halstead SB, Streit TG, Lafontant JG. Haiti: the absence of dengue hemorrhagic fever despite hyperendemic dengue virus transmission. Am J Trop Med Hyg 2001;65:180–3.
Huang YH, Lei HY, Liu HS, Lin YS, Liu CC, Yeh TM. Dengue virus infects human endothelial cells and induces IL-6 and IL-8 production. Am J Tropic Med Hyg. 2000;63(1):71-5.
Kabra SK, Jain Y, Pandey RM, Singhal T, Tripathi P, Broor S, et al. Dengue haemorrhagic fever in children in the 1996 Delhi epidemic. Transact Roy Soc Tropic Medic Hyg. 1999;93(3):294-8.
Kalayanarooj S, Chansiriwongs V, Nimmannitya S. Dengue patients at the Children’s Hospital, Bangkok: 1995–1999. Review. Dengue Bulletin 2002;26:33–43.
King CA, Marshall JS, Alshurafa H. Release of vasoactive cytokines by antibody- enhanced dengue virus infection of a human mast cell/basophil line. J Virol 2000;74:7146–50.
Kuno G, Gubler DJ, Santiago de Weil NS. Antigen capture ELISA for the identification of dengue viruses. J Virol Methods 1985;12:93–103.
Library DH, Young PR, Pickering D. High circulating levels of the dengue virus nonstructural protein NS1 early in dengue illness correlate with the development of dengue hemorrhagic fever. J Infect Dis 2002;186:1165–8.