Dengue fever and dengue haemorrhagic fever in adolescents and adults

Pathogenesis of dengue haemorrhagic fever is not fully understood, but it is thought that there is antibody enhancement during the secondary infection, which causes severe dengue haemorrhagic fever (DHF). Therefore, patients who have DHF should have a documented history of symptomatic dengue infection in the past. A retrospective descriptive-analytical study was conducted at the University Paediatric Unit at Lady Ridgeway Hospital for Children, Colombo, Sri Lanka. All children who had fulfilled the criteria for DHF admitted to the unit from April 2018 to September 2018 were recruited into the study. Relevant data were collected from bed head tickets. One hundred and eighty-four children were included in the final analysis. Thirty-three (17.9%) had a past history of documented symptomatic dengue infection, while 82.1% did not have a documented dengue infection. Twelve patients had dengue shock syndrome, and none of them had previously documented symptomatic dengue fever. Dextran was used in 96 patients in the critical phase. Twelve (42%) patients with past documented symptomatic dengue fever needed dextran while 84 (54.9%) patients without a documented past history of dengue fever needed dextran. In our clinical observation, we noticed that children with DHF mostly did not have a documented symptomatic prior dengue infection, while those with a documented symptomatic prior infection had a milder subsequent illness. In fact, the majority (82.1%) of patients with DHF did not have documented previous symptomatic dengue infection. It was also observed that the clinical course of subsequent dengue infection was less severe in patients with previously documented symptomatic dengue fever. This finding should be further evaluated in a larger scale study minimizing the all-confounding factors. This fact is more important in selecting recipients for vaccines against the dengue virus, which are supposed to produce immunity against the virus without causing the severe disease.

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Clinical Profile of Dengue Fever in Children

Bangladesh Journal of Child Health ◽

10.3329/bjch.v33i2.5678 ◽

1970 ◽

Vol 33 (2) ◽

pp. 55-58 ◽

Cited By ~ 2

Author(s):

ABM Shahidul Alam ◽

S Anwar Sadat ◽

Zakaria Swapan ◽

Aftab U Ahmed ◽

Md Nazmul Karim ◽

...

Keyword(s):

Abdominal Pain ◽

Dengue Fever ◽

Dengue Infection ◽

Cross Sectional Study ◽

Dengue Haemorrhagic Fever ◽

Published Data ◽

Haemorrhagic Fever ◽

Cross Sectional ◽

Normal Platelet ◽

The Mean

Background: Dengue infection has become endemic in Bangladesh since it hasbeen broken out in June 2000. Although children are the usual victim of dengueinfection, there is paucity of published data regarding dengue infection in children inour country.Objectives: This study was designed to document the presenting features and outcomeof Dengue infection in children.Materials and Methods: This cross sectional study was done among the childrenhaving Dengue infection. Fifty four consecutive patients were enrolled. Purposivesampling was done. In every patient a detailed history was taken. Clinical examinationsand relevant investigations were done. Data were collected in a predesigned structuredquestionnaire. Data were analyzed with the help of descriptive statistics and Chisquare(x2) Test.Results: The mean age of the patients was 6.5±3.5 years with equal male and femaleratio. Among 54 patients, 40.7% presented with dengue fever (DF), the rest (59.3%)presented with dengue haemorrhagic fever (DHF). Most of the patients presented withhigh grade continued type of fever (75.9%), followed by abdominal pain (59.3%),vomiting (57.4%). Itchy rash and fever were the most important characteristic signs(75.9% each). Flushed appearance observed in 68.4% and 59.3% patients showedbleeding manifestation of which sub-conjunctival haemorrage was the commonestform (33.3%). Leucopenia were present in only 9.3% of the patients. Platelet countless than 100×109/L were found in 68.5% patients. Tourniquet test was positive in31.5% of cases. All of the patients had packed cell volume (PCV) less than 45%.Raised serum alanine aminotransferase (ALT) was observed in 40.7% of children.IgM and/or IgG antibodies for dengue virus were positive in 96.29% patients. Majority(94%) of the patients completely recovered from the disease and only 6% died.Conclusion: High grade continued fever, vomiting with abdominal pain and itchy skinrash (with normal platelet count) were the presenting features. Commonest form ofbleeding manifestation was subconjunctival haemorrhage. Bleeding manifestationhad a significant association with the degree of thrombocytopenia but no corelationwas observed with tourniquet test positivity.Key words: Dengue fever (DF); dengue haemorrhagic fever (DHF); paediatric.DOI: 10.3329/bjch.v33i2.5678Bangladesh Journal of Child Health 2009; Vol.33(2): 55-58

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Dengue: A Practical Experience of Medical Professionals in Hospital

Journal of Medicine ◽

10.3329/jom.v13i2.12751 ◽

2012 ◽

Vol 13 (2) ◽

pp. 160-164

Author(s):

Quazi Tarikul Islam ◽

Ariful Basher ◽

Robed Amin

Keyword(s):

Dengue Fever ◽

Hospital Care ◽

Prospective Observational Study ◽

Biochemical Marker ◽

Practical Experience ◽

Dengue Haemorrhagic Fever ◽

Medical Professionals ◽

Clinical Parameters ◽

Haemorrhagic Fever ◽

M 31

Background: Dengue remains endemic and frequently intensifies into epidemics in Bangladesh since 2000 resulting in frequent hospitalizations. Materials & Methods: A prospective observational study was carried out to determine the clinical parameters of the subjects for hospitalization and the pattern of presentation of dengue fever in hospital care from July, 2010 to December, 2010. Result: Total 50 cases were selected consecutively and diagnosed clinically as dengue, and were classified into 3 groups, i.e. 25 cases of classical dengue fever, 3 cases of dengue fever with unusual haemorrhage, 22 cases Dengue haemorrhagic fever (DHF-I and DHF-II) and all were discharged uneventfully. Among them 33(66%) were male and outnumbered 17(34%) were female. Mean ages of the subjects were 30.91 ±10.314, 34.33 ± 16.29 and 33.91 ± 14.72 years in respective groups. Majority had profound weakness, headache, myalgia, anorexia, nausea, and vomiting and itching. Diarrhoea, abdominal pain, organomegaly, ascites, and pleural effusion were not infrequent complaints of Dengue haemorrhagic fever patients, whereas occasional complaints in other groups. There is a linear relationship between platelet count and SGPT (p-0.037). Hametocrit value also markely increased in dengue haemorrhagic fever (m- 42.5) but not in dengue fever with unusual haemorrhage (m-31). Biochemical marker specially Hct may be a good predictor to differentiate different presentation of dengue fever. Conclusion: Patients with dengue syndrome showed varied presentation and the symptoms were nonspecific. So much attention has to be paid for early diagnosis and management. DOI: http://dx.doi.org/10.3329/jom.v13i2.12751 J Medicine 2012; 13 : 160-164

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Child with dengue haemorrhagic fever complicated by ileocaecal intussusception

BMJ Case Reports ◽

10.1136/bcr-2020-237697 ◽

2021 ◽

Vol 14 (3) ◽

pp. e237697

Author(s):

Vijayakumary Thadchanamoorthy ◽

Kavinda Dayasiri

Keyword(s):

Acute Abdomen ◽

Dengue Fever ◽

Neglected Tropical Diseases ◽

Point Of Care ◽

Initial Point ◽

Operative Management ◽

Dengue Haemorrhagic Fever ◽

Emergency Laparotomy ◽

Point Of Care Ultrasound ◽

Haemorrhagic Fever

Dengue fever is one of the most common neglected tropical diseases with an increasing trend seen in Sri Lanka and many other tropical countries. A number of unusual presentations and complications of dengue fever have been reported, and acute abdomen is one such presentation. However, intussusception as the cause of acute abdomen in a patient with dengue haemorrhagic fever has not been previously reported. The authors report a child who was diagnosed to have intussusception during the critical phase of dengue haemorrhagic fever while having a platelet count of 15×103/cumm. The child had initial point-of-care ultrasound followed by detailed ultrasound of the abdomen by the radiologist, and the diagnosis of ileocaecal intussusception was confirmed. Intussusception was relieved by saline reduction and without needing laparotomy. Early diagnosis and non-operative management prevented emergency laparotomy.

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Role of C- reactive proteins and liver function tests in assessing the severity of dengue fever

Journal of the Pakistan Medical Association ◽

10.47391/jpma.170 ◽

2020 ◽

pp. 1-17

Author(s):

Akash Khetpal ◽

Ansab Godil ◽

Muhammad Tanveer Alam ◽

Inam ul Haq Muhammad Makhdoom ◽

Arsalan Majeed Adam ◽

...

Keyword(s):

Liver Function ◽

Dengue Fever ◽

Dengue Shock Syndrome ◽

Liver Function Tests ◽

Dengue Haemorrhagic Fever ◽

Severe Dengue ◽

Haemorrhagic Fever ◽

C Reactive Protein ◽

Reactive Protein ◽

Function Tests

Abstract Objective: To determine whether C-reactive protein and liver function tests can serve as severity markers for dengue fever. Methods: The cross-sectional study was conducted in 2015-16 in Karachi and comprised patients with dengue fever visiting a tertiary care hospital. World Health Organisation classifications 1997 and 2009 were used to categorise patients according to clinical signs and symptoms. Receiver Operating Characteristics curve was used to determine discriminative ability and optimum cut-off value of biochemical markers. Comparisons were done through one-way analysis of variance using SPSS 17. Results: Of the 218 patients, 133(61%) were males and 85(39%) were females. The overall mean age was 35.07+15.96 years. Levels of C-reactive protein and total bilirubin were significantly higher for dengue haemorrhagic fever compared to dengue fever; dengue shock syndrome compared to dengue fever; dengue shock syndrome compared to dengue haemorrhagic fever; and dengue shock syndrome compared to dengue fever / dengue haemorrhagic fever (p<0.05 each). Levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were significantly higher for dengue shock syndrome compared to dengue fever; dengue shock syndrome compared to dengue haemorrhagic fever; and dengue shock syndrome compared to dengue fever / dengue haemorrhagic fever (p<0.05 each). Levels of C-reactive protein, total bilirubin, alanine aminotransferase and alkaline phosphatise in patients with severe dengue were significantly higher compared to non-severe dengue. Conclusion: C-reactive protein and liver function tests were found to be effective biochemical markers in assessing dengue fever severity.

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