Clinical and laboratory profile and outcome of dengue cases among children attending a tertiary care hospital of South India


  • Punith Patak Nagaram Department of Paediatrics, Narayana Medical College, Andhra Pradesh, India
  • Prathima Piduru Department of Paediatrics, Narayana Medical College, Andhra Pradesh, India
  • Venkata Krishna Munagala Department of Paediatrics, Narayana Medical College, Andhra Pradesh, India
  • Vishnu Vandana Matli Deapartment of Paediatrics, KIMS Hospital, Nellore, Andhra Pradesh, India



Dengue fever, Dengue Hemorrhagic fever, Haematocrit, Hepatomegaly


Background: Dengue fever is an arboviral disease which is endemic in tropical countries and is of major concern with its morbidity and mortality. WHO classified dengue into three categories: undifferentiated fever, dengue fever (DF) and dengue haemorrhagic fever (DHF). Severe dengue is also regularly observed during primary infection of infants born to dengue-immune mothers. The objective of present study was to assess the clinical profile, laboratory profile and associated risk factors related to outcome of children less than 15 years of age. The outcome of the children and their management protocols were also assessed in the study.

Methods: A prospective cross sectional study with 174 confirmed cases of dengue in children <15 years were enrolled and classified as per WHO guidelines. The demographic data, clinical history, laboratory parameters were noted in a separate questionnaire form. Hematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done and observations noted. Cases were managed as per WHO protocol and risk factors were observed. The outcomes of the cases were noted as discharge or death of the case.

Results: A total of 174 children with 149 non-severe dengue and 25 severe dengue cases with 95 males and 79 females were enrolled in the study. 6-10 years was the most common age group. The mean age of children admitted with severe dengue fever was 5.81yrs.and without severe dengue fever was 7yrs.The mean duration of hospitalization was 5.21 days in severe dengue and 3.4 days in non-severe dengue cases. Fever was the most common presenting symptom and hepatomegaly was the common clinical finding in the study.  Bleeding manifestations were seen in cases of severe dengue with raised haematocrit levels, raised SGOT levels and severe thrombocytopenia. Pleural effusion and gall bladder wall thickening with ascites was seen in severe dengue cases. Management was by administration of colloids and crystalloids.

Conclusions: Dengue is a dreadful fever among pediatric age group which needs to be considered with great caution in management.  Understanding the risk factors helps in predicting the mortality which helps in management and better outcome of the fever. 


WHO. Dengue and dengue haemorrhagic fever. Factsheet No 117, revised May 2008. Geneva, World Health Organization, 2008 (

Gupta N, Srivastava S, Jain A, Chaturvedi UC. Dengue in India. Indian J Med Res. 2012;136(3):373-90.

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;368:170-3.

Rigau-Perez J. Severe dengue: the need for new case definitions. Lancet Infect Diseases. 2006;6:297-302.

Halstead SB, Nimmannitya S, Cohen SN. Observations related to pathogenesis of dengue hemorrhagic fever. IV. Relation of disease severity to antibody response and virus recovered. Yale J Biol Medic. 1970;42:311-28.

Sangkawibha N, Rojanasuphot S, Ahandrik S, Viriyapongse S, Jatanasen S, Salitul V et al. Risk factors in dengue shock syndrome: a prospective epidemiologic study in Rayong, Thailand. I. The 1980 outbreak. Am J Epidemiol. 1984;120:653-69.

Guzman MG, Kouri G, Valdes L, Bravo J, Alvarez M, Vazques S et al. Epidemiologic studies on dengue in Santiago de Cuba, 1997. Am J Epidemiol. 2000;152(9):793-9.

Halstead SB. Pathophysiology and pathogenesis of dengue haemorrhagic fever. In: Thongchareon P, ed. Monograph on dengue/dengue haemorrhagic fever. New Delhi, World Health Organization, Regional Office for South-East Asia; 1993:80-103.

Kabilan L, Balasubramanian S, Keshava SM, Thenmozhi V, Sekar G, Tewari SC et al. Dengue disease spectrum among infants in the 2001 dengue epidemic in Chennai, Tamil Nadu, India. J Clin Microbiol. 2003;41(8):3919-21.

Dhooria GS, Bhat D, Bains HS. Clinical profile and outcome in children of dengue hemorrhagic fever in North India. Iran J pediatr. 2008;18(3):222-8.

Sharma NL, Balasubramanyam V, Kandati J, Ponugoti M. Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India. Int J Contemp Pediatr. 2017;4:110-5.

Mishra S, Ramanathan R, Agarwalla SK. Clinical profile of dengue fever in children: a study from Southern Odisha, India. Scientifica. 2016;Article ID


Aggarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK. An epidemic of dengue hemorrhagic fever and dengue shock syndrome in children in Delhi. Indian Pediatr. 1998;35:727-32.

Guzmán MG, Kouri G, Bravo J, Valdes L, Susana V, Halstead SB. Effect of age on outcome of secondary dengue 2 infections. Int J Infect Diseas. 2002;6(2):118-24.

Gomber S. Hematological observations as diagnostic markers in dengue hemorrhagic fever. Indian Pediatr. 2001;38:477-81 ,

Agarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK. An epidemic of dengue hemorrhagic fever and dengue shock syndrome in children in Delhi. Indian Pediatr. 1998;35:727-32.

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.

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.

Mairuhu ATA. Coagulation abnormalities in dengue virus infections: more common than currently received. Report of a Collaborative Study. 2010;28(2):107-10.

Kumar ND, Tomar V, Singh B, Kela K. Platelet

transfusion practice during dengue fever epidemic, PMID: 12583421.

Gupta V, Yadav TP, Pandey RM, Singh A, Gupta M, Sharma A et al. Risk factors of dengue shock syndrome in children. J Tropic Pediatr. 2011;57(6):451-6.

Srivastava VK, Suri S, Bhasin A, Srivastava L, Bharadwaj M. An epidemic of dengue hemorrhagic fever and dengue shock syndrome in Delhi-A clinical study. Ann Trop Pediatr. 1990;10:329-34.

WHO 2009 Dengue guidelines for diagnosis, treatment, prevention and control.






Original Research Articles