Trends of fluid requirement in dengue fever and dengue haemorrhagic fever: a single centre experience in Sri Lanka

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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