scholarly journals Retrospective study of clinical profile and outcome of pediatric dengue cases in a teaching hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 226
Author(s):  
Alok Kumar M. K. ◽  
Timmangouda R. Patil ◽  
Santhosh Veerabadhraiah

Background: Dengue fever is an acute febrile illness caused by 4 closely related viral serotypes of the genus Flavivirus. Dengue has a broad range of clinical manifestations and often with unpredictable clinical evaluation and outcome. So this study has been done to see the wide range of clinical presentation of dengue and its outcome.Methods: It is a retrospective study done in tertiary hospital during the period of 8 months. Study was done by collecting the previous records from hospital record section. There were 48 cases of serologically confirmed cases of dengue which satisfied the inclusion and exclusion criteria were included in the study. Results: In our study there were 52% of the cases of dengue fever, 16.6% of cases were dengue fever with warning signs and remaining 31.4% of patients were severe dengue. Common Clinical symptoms at admission were fever (100%), vomiting (77%), respiratory distress (56.25%), generalised weakness (54.1%) and pain abdomen (33.3%). Less common symptoms were loose stools (6.25%), periorbital puffiness (6.25%), altered sensorium (4.1%), oliguria (2%) and bleeding manifestations (2%). Out of these dengue children 70.8% of these children improved without complication, 20.8 % of children improved with complication, in the form of ARDS, acute liver failure, DSS, meningitis, 6.25 % of these children went DAMA and  2 % of children expired.Conclusions: In our study atypical presentations like respiratory distress, loose stools meningitis were commonly noted and bleeding manifestation at admission was rare in our study. Platelet transfusions have little role in management of dengue patients. Early diagnosis, careful monitoring and proper fluid management goes a long way in reducing the mortality due to dengue hemorrhagic fever and shock syndrome.  


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bui Vu Huy ◽  
Le Nguyen Minh Hoa ◽  
Dang Thi Thuy ◽  
Nguyen Van Kinh ◽  
Ta Thi Dieu Ngan ◽  
...  

Purpose. The clinical features and laboratory results of dengue-infected adult patients admitted to the hospital during the 2017 outbreak were analyzed in this study. Method. This is a cross-sectional study. 2922 patients aged 18 years or more with dengue fever in National Hospital for Tropical Diseases (NHTD) in the North and Hospital for Tropical Disease (HTD) in the South of Vietnam were recruited in this study. Result. Patients were admitted in the hospital around the year and concentrated from August to December, in 53/63 (84.0%) provinces in Vietnam, and patients in all ages were affected. The number of patients with dengue fever was 1675 (57.3%), dengue with warning signs 914 (31.3%), and severe dengue 333 (11.4%), respectively. Among patients with severe dengue, severe plasma leakage and dengue shock account for 238 (8.1%), severe organ impairment 73 (2.5%), and severe bleeding 22 (0.75%). The rate of mortality was 0.8%, and the outcome of dengue patients is worse in the elderly and people with underlying diseases. Conclusion. The 2017 dengue outbreak occurred in a larger scale than in the previous years in terms of time, location, and number of patients. More elderly patients were infected by dengue in this outbreak, and this may contribute to the mortality rate. Clinical manifestations of dengue patients in Southern Vietnam are more typical than the northern, but the rate of severe dengue is not different. The mortality risk and underlying conditions associated with dengue-infected elderly patients are worthy of further investigations in the future.



2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S928-S929
Author(s):  
Manish Soneja ◽  
Manasvini Bhatt ◽  
Faraz A Farooqui ◽  
Naval K Vikram ◽  
Ashutosh Biswas ◽  
...  

Abstract Background Cardiac involvement in dengue fever is underdiagnosed due to low index of suspicion and overlapping clinical manifestations of capillary leak associated with dengue. The frequency of subclinical dengue myocarditis and its relative contribution to the hemodynamic instability in severe dengue needs to be explored. We studied the prevalence of myocarditis and clinical outcomes among admitted patients with dengue. Methods A prospective observational study was carried out in admitted patients with age between 18 and 65 years having confirmed dengue (NS1/IgM ELISA). Patients with electrolyte abnormalities or on medications affecting heat rhythm/ rate, pre-existing heart disease were excluded. The baseline demographic, clinical and laboratory parameters were collected. A baseline ECG was done and repeated every second day. Trop-I and NT-proBNP were done at baseline and repeated only if elevated at baseline or there were ECG changes. The cardiac enzymes were measured using enzyme-linked fluorescent assay (VIDAS, bioMérieux, France). Patients with elevated enzymes underwent 2-dimensional echocardiography. Diagnosis of myocarditis was as per ESC 2013 criteria. Fluid management was as per WHO guidelines (2009). Results A total of 183 patients were recruited with median age of 29 years (IQR 21, 37) and 31% were females. Dengue with warning signs was present in 80 (44%) and severe dengue in 45 (25%) patients. Cardiac enzymes were elevated in 27 (15%) patients (cTnI in 25, NT-proBNP in 22). Among these 27 patients, 11 [6% (2.6–9.4, 95% CI)] had echo evidence and diagnosed as having myocarditis according to ESC 2013 criteria (Figure 1). Clinical features of fluid overload were more common in myocarditis group [8 (73%) vs 4 (2%), P = Overall, 5 (2.7%) patients expired, all of them had myocarditis (5/11 = 45%). These patients had severe dengue, 2 patients developed hospital-acquired pneumonia and 1 had malaria co-infection. Among patients with raised enzymes and normal echo (n = 16), 3 patients developed clinical signs of fluid overload compared with only 1 out of 156 patients without raised enzymes (P < 0.01). Conclusion Myocarditis in admitted patients with dengue is not uncommon [6% (2.6–9.4, 95% CI)] and may lead to a complicated disease course. Disclosures All authors: No reported disclosures.



2018 ◽  
Vol 5 (5) ◽  
pp. 1801
Author(s):  
Reshma Raj ◽  
Rashmi Alva

Background: Dengue fever is one of the most common arbo virus mediated outbreaks, being reported from different parts of the world. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. Aim of this study is to document the serum Sodium level in dengue infected children in a tertiary care centre.Methods: A total 128 cases of NS1 antigen, IgM positive or ELISA positive dengue patients were included in this observational study and analyzed.Results: The serum Sodium level in dengue varies according to the different groups. In group A (dengue with no warning signs) the serum Sodium level was normal, whereas in case of group B (dengue with warning signs), there was significant hyponatremia. In group C, severe dengue the serum Sodium was normalConclusions: Mild hyponatremia is a common electrolyte disturbance in patients with dengue with warning signs. Hence, the lower the serum Sodium levels the higher is the incidence of complications associated with dengue fever.



2016 ◽  
pp. 95-100
Author(s):  
Vu Phong Le ◽  
Trung Tien Phan ◽  
Thi Phuong Thao Nguyen ◽  
Xuan Chuong Tran

Background: Dengue fever (DF) is one of the most popular viral infectious disease nowadays. The DF outbreak in 2013 have many patients with severe clinical manifestations, complications and difficult prognosis. Aims: "Survey clinical characteristics and some of serve prognostic factors in adults dengue fever”. Patients and methode: All patients over 15 years old were diagnosed dengue fever hospitalized Hue Central Hospital from January 2013 to December 2013. Retrospective study. Results: Among 1305 patients, male 48.0%, females 52.0%. Averages age 27.7 ± 11.8 (age). The highest age: 84 years old, lowest: 15 years old. The age group of 15-30 accounted for the highest percentage (70.9%). Patients over 40 years old accounted for 14,2% rate. Dengue fever is the most popular (76.6%). There are 5.6% patients were grouped Serve dengue. Dengue fever with warning signs (22.4%) in women higher than in male (12.5%) (p < 0.001). Platelets small than 50 G/L; ages over 40 years old and HCT over 50 percentage is the risk of serve dengue fever statistical significance (p< 0.001). Conclusion: The ratio male: female is equal. Patients over 40 years old have tendency to increase.The risk factors of Serve Dengue are Increasing HCT more than 50 percentage; ages over 40 year olds and platelets small than 50 G/L. Key words: dengue fever, hue Central Hospital



2021 ◽  
Vol 20 (1) ◽  
pp. 46-50
Author(s):  
Mitra Datta ◽  
Asma Ferdousi ◽  
Salina Haque ◽  
Rifat Jahan ◽  
Aparup Das ◽  
...  

 Background: Dengue outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. This study was aimed to describe the clinico-epidemiological profile and outcome of dengue infected children during 2019 dengue outbreak in Chattogram. Materials and methods: This hospital based prospective observational study was carried out in the Department of Pediatrics in Chattogram Medical College Hospital. Serologically positive dengue cases (Aged £12 years) admitted from July 2019 to December 2019 were enrolled in the study. Hospital outcome of the patient’s was recorded in terms of mortality, Length of Hospital Stay (LOS) need for ICU. Results: Out of total 192 patients as per the National Guideline 66.7% cases were classified as dengue fever without warning signs, 21.9% as dengue fever with warning signs and 11.5% as severe dengue. Overall the mean age was 7.04 (±3.23) years with male preponderance (59%). Along with fever main complaints were abdominal pain (91.7%), vomiting (47.9%) and headache (23.6%). Marked thrombocytopenia (Below 50,000) was present in 37.9%, leucopenia in 27.9% and raised haematocrit in 10.9% of cases. Average LOS was 5.2 (±1.9) days, 18 (9.5%) patients need ICU admission and there was no fatality in this series. Some clinical (Vomiting, flusihing, shock, reduced urinary output) and laboratory (Marked thrombocytopenia, leucopenia, hemoconcentration, pleural effusion and hepatomegaly) variables were associated with severity. Conclusion: Fever with abdominal pain were common presentations of dengue fever. Severe dengue patients presented with vomiting, flashing and shock. Marked thrombocytopenia and pleural effusion and/or ascites were related to shock. Appropriate and timely management is very effective in reducing case fatality. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 46-50



2020 ◽  
Vol 7 (9) ◽  
pp. 1864
Author(s):  
Deepthy Alice Varghese ◽  
Shivaprakash Sosale C. ◽  
Keshavmurthy . ◽  
Anusha P. P. ◽  
Chikkanarasa Reddy

Background: Dengue is a vector borne diseases with varied clinical manifestations, a major concern to public health globally. This study was done to describe the salient clinical as well as haematological profile of serologically confirmed cases of dengue fever and outcome in admitted cases.Methods: This was a prospective study conducted at major Government teaching Hospitals in Bangalore from July 2019 to December 2019. Total 164 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire format. Haematological parameters on admission, duration of stay and outcomes were analysed. The outcomes of the cases were mentioned as improved and death.Results: In this study commonly affected age band was adolescents group (36.6%) without any sex predilection. Maximum number of dengue cases were presented with warning signs (87.5%), 14 (8.69%) cases without warning signs and 6 (3.72%) with severe dengue. Fever was the most common symptom (100%), followed by vomiting (58%) and abdominal pain (38.5%). NS1 antigen positive cases (61.5%). Severe Leukopenia was present in 57% of cases and Thrombocytopenia in all admitted patients (100%). Most of the cases were treated with antipyretics, oral fluids (46%) and IV fluids (53%), only single case received platelet transfusion. Duration of stay was more in severe dengue cases. Mortality of our study was 1.8%.Conclusions: Dengue presents with varied clinical features. Community awareness, early diagnosis and management and vector control measures needs to be strengthened in order to reduce the increasing number of dengue case. Both clinical, haematological parameters should be monitored for better outcome.



2021 ◽  
pp. 54-55
Author(s):  
Abhay John Gray ◽  
Sheela Mathew ◽  
Gayathri R ◽  
Akhila Arya ◽  
Aswathy MA ◽  
...  

Introduction: Dengue is a systemic viral infection caused by the virus from genus Flaviviridae. Dengue infection has got a wide clinical spectrum that includes both severe and non-severe clinical manifestations. The group progressing from non-severe to severe disease is difcult to dene. Early detection and access to proper medical care signicantly lower fatality rates and would help to reduce the burden of hospital stay and economy loss. Objectives: To study the inammatory markers predicting the severity of dengue infection. Methods: 250 diagnosed patients were evaluated with detailed history, physical examination and blood investigations. Inammatory markers associated with severity of dengue were studied. Observations and conclusions- 97 patients (39%) had dengue without warning signs, 62(25%) had dengue with warning signs, 63(25%) had severe dengue and 28(11%) had expanded dengue. Low CRP, ESR, HDL and LDL cholesterol were observed in dengue fever, without any statistical signicance. Ferritin levels more than 1000 and triglyceride more than 200 was signicantly associated with severity of dengue.



Author(s):  
Radheshyam Purkait ◽  
Rajarshi Basu

Background: Many parts of India, including the eastern regions, are now endemic for the dengue infection with increased recognition of atypical neurological manifestations apart from the classical clinical features.Methods: This prospective study was conducted in the department of paediatrics in a tertiary care teaching hospital in eastern India from July 2019 to November 2019 to determine the changing trends of the clinical features in the dengue patients of this region in the recent years among paediatric populations. All the serologically confirmed dengue patients admitted during this period satisfying the inclusion criteria were enrolled in the study population and classified as per new WHO-2009 classification into: dengue fever without warning signs (DF), dengue fever with warning signs (DFWS) and severe dengue (SD). Detailed history, clinical and laboratory parameters were recorded and analysed for all children.Results: Out of the total of 110 cases, 16 cases (14.55%) were DF, 80 cases (72.73%) were DFWS and 14 cases (12.73%) were SD. The commonest age group affected (63.64 %) was between 4-<10 years. The male: female ratio of cases was 1.68:1. Besides classical clinical manifestations, we observed CNS involvement in nine cases (8.18%). Among them, five patients had dengue encephalitis, two patients had dengue encephalopathy, one patient had hypokalemic paralysis and one patient had Guillain-Barré syndrome. All the patients were treated as per standard guidelines.Conclusions: Clinician must be aware of such association during dengue outbreak because early diagnosis and appropriate supportive care can reverse this potentially fatal disease.



2020 ◽  
Vol 7 (11) ◽  
pp. 2115
Author(s):  
R. Malai Arasu ◽  
P. Jagadeesan

Background: Dengue is the most prevalent mosquito-borne viral disease worldwide. It is endemic to hyperendemic in various parts of India. Symptomatic dengue infection causes a wide range of clinical manifestations, from mild dengue fever to potentially fatal disease, such as dengue hemorrhagic fever or dengue shock syndrome. Aim of the study was to analyze the clinical profile of children affected by dengue fever.Methods: A total of 250 who had dengue fever serologically positive cases had included in this study. All the demographic and clinical history and laboratory diagnosis had collected from the study people and written informed consent form had obtained from the patient. Results were statistically analyzed and discussed.Results: Based on symptoms all the 250 patients had a fever, 219 patients had vomiting, 209 patients had a loss of appetite, 197 patients had abdominal pain, 160 patients had body/leg pain, 135 patients had a headache/ retro-orbital pain, 91 patients had abdominal distension, 81 patients had skin rashes, 53 patients had bleeding disorders, and 7 patients had a convulsion. 99 patients had an undifferentiated fever, 115 patients had dengue fever, and 43 patients had severe dengue fever. 75 patients had platelet count of 50,000-1,00,000/mm3, 34 patients had 20,000-50,000/mm3and 12 patients had less than 20,000/mm3 platelet count.Conclusion: The majority had common presenting symptoms of fever, vomiting, headache and body pain. No deaths have occurred in this study. Conservative management strategy with rational platelet transfusion is effective in managing dengue patients. 



2020 ◽  
Vol 11 (SPL2) ◽  
pp. 175-180
Author(s):  
Radha Kumar ◽  
Ganthimathi Sekhar ◽  
Ananthi N ◽  
Kalyani M

Dengue fever is one of the most commonly occurring mosquito borne-viral illnesses that has a wide range of presentation in children and is common during the monsoon season. The severity of illness ranges from mild undifferentiated fever, dengue with warning signs, severe dengue fever and dengue fever with organ dysfunction. The symptoms of dengue may be easily mistaken for those of flu or other viral infections. Contrary to other fevers, complications in dengue occur during the phase of defervescence and can be life threatening in children due to shock or profuse hemorrhage. 55 dengue positive children who were diagnosed by dengue antigen detection or dengue antibody positive were included in the study. Most of children were above 10 years and the commonest presenting symptoms were fever, headache, body pain, nausea, anorexia, abdominal pain and vomiting. Most of the children presented with two or more warning signs like persistent vomiting, thrombocytopenia, increasing hematocrit and hepatomegaly. Few children developed features of early shock, which was diagnosed early and treated effectively. All the children responded well to treatment measures and recovered well during hospital stay. Having a high of suspicion and careful monitoring of children is crucial for reducing occurrence of complications and death due to this severe infection.



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