Clinical profile and prognosis of severe dengue infection in pediatric population admitted to tertiary care hospital
DOI:
https://doi.org/10.18203/2349-3291.ijcp20231836Keywords:
Clinical profile, Dengue fever, Predictors for mortality, Severe dengue casesAbstract
Background: Dengue fever is one of the most important emerging vector-borne viral diseases. Approximately 500,000 out of 100 million cases develop severe dengue infection. Dengue infection is endemic to Bangladesh and presents with varying degrees of severity of illness in Bangladeshi children. Objectives was to assess the common clinical profile, biochemical findings associated with severe dengue fever, and their outcome in children less than 14 years of age.
Methods: This was an observational study conducted from April 2022 to October 2022 at the Pediatrics Department of Dhaka Medical College Hospital and Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Results: A total of 150 cases were classified as severe dengue. The most common age of presentation was 6-8 years. The most common presenting symptom was fever (97.3%) followed by abdominal pain and vomiting (77.3%) followed by shock in 94 cases (62.7%) of severe dengue. Pleural effusion was the most common physical finding seen in 70 cases (46.6%) followed by ascites in 52 cases (34.7%). Elevation in aspartate transaminase AST (IU/L) was found in 60.0%, low albumin was found in 78.7% of the cases. Hyponatremia was the most common electrolyte abnormality found in 70 cases (46.7%). Regarding coagulation profile raised D-dimer and low fibrinogen were found in 106 cases (70.7%) and 84 cases (56.0%) respectively. Activated partial thromboplastin time (aPTT) was prolonged in 37.3% of cases. The case fatality rate (CFR) was (5.3%).
Conclusions: Abdominal pain and vomiting, shock, as-cities and pleural effusion were dominant features of severe disease. Raised AST and D-dimer, low fibrinogen and albumin level as well as hyponatremia are very significant findings in severe disease. Early suspicion and effective management can reduce the severity.
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