scholarly journals Clinical profile and outcome of dengue fever in a paediatric tertiary care centre

2017 ◽  
Vol 4 (3) ◽  
pp. 875
Author(s):  
Md Khaja Moinuddin ◽  
Sahana Devadas Sahana Devadas

Background: A study of different presentation and outcome of dengue fever in tertiary care centre.Methods: the observational cross sectional study was carried out from June to October 2016 in Bowring and Lady Curzon hospital attached to Bangalore Medical College and Research Institute. Included patients from 1 to 18 years of age who presented with febrile illness. WHO classification and definitions were used to classify disease as dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Clinically, haematological and biochemical findings were recorded till discharge.Results: during study period,142 patients presented with typical features of dengue fever, male being 86 (60%) and female being 56 (40%). Among 142 cases 64 cases were probable dengue, 50 cases were dengue with warning signs and 28 cases were had severe dengue. Fever (100%) was the most common clinical presentation followed by vomiting (70%), body ache (43%), abdominal pain (23%), headache (12%) and rashes (5%). Laboratory findings included thrombocytopenia, leucopenia and elevated liver enzymes. 126 (88%) cases were discharged in clinical stable conditions, (8%) were died during course of treatment and 8 cases left against medical advice.Conclusions: fever with vomiting and thrombocytopenia were most common presentation of dengue fever, appropriate clinical diagnosis and management is relatively simple, inexpensive and very effective in saving lives as long as long correct and timely interventions instituted. 

2020 ◽  
Vol 13 (2) ◽  
pp. 173-177
Author(s):  
Namrata K.C. ◽  
Krishna Bahadur Thapa ◽  
Nirmala Shrestha ◽  
Shankar Paudel ◽  
Chandra Bahadur Pun

Introduction: Dengue, the arthropod borne viral disease is serious public health problem in Nepal. The clinical diagnosis of dengue has become challenging in children as it is presented with nonspecific symptoms. The objective of present study was to assess different clinical presentations and outcomes of dengue fever in tertiary care centre. Methods: A record based observational cross-sectional study was carried out on all dengue positive patients of aged 11 months to 15 years presented in Gandaki Medical College from July to November 2019. Total 74 patients with history of fever with dengue seropositive were included in the study. All the clinical and haematological findings were recorded in semi-structured questionnaire form. Results: Of 74 patients 40 (54.1%) males and 34 (45.9%) were females. Fiftyone (68.9%) were cases of dengue without warning sign, 18 (24.3%) were dengue with warning signs and 5(6.8%) cases had severe dengue symptoms. Most of the patients (78.38%) were from Kaski district. Fever (100%) was the most common clinical presentation followed by headache (36.5%), vomiting (25.7%), and retro orbital pain (20.3%). Common laboratory findings included thrombocytopenia (59.4%) and leukopenia (35.1%). Among 74 cases, 68 were in stable condition and treated in OPD or in ward, and 6 were admitted in ICU of which one developed warning signs and other 5 had severe dengue. All the enrolled children recovered well and there was no mortality during this period. Conclusions: Fever, headache, vomiting, thrombocytopenia and leukopenia were most common presentation of dengue fever among children. Appropriate clinico-laboratory diagnosis and management is relatively simple, inexpensive and very effective in saving lives as long as correct and timely interventions are instituted.  


2018 ◽  
Vol 5 (6) ◽  
pp. 2265 ◽  
Author(s):  
Senthil Kumar K. ◽  
Rajendran N. K. ◽  
Ajith Brabhukumar C.

Background: In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. The objective of this study is to assess the clinical profile of the dengue infection in children less than 15 years of age and to evaluate the outcomes of dengue fever from March 2017 to July 2017 at the Pediatric Department of Karuna Medical College, the tertiary care hospital in Palakkad.Methods: In this retrospective study, medical records were reviewed and analyzed. Patients with suspected dengue infection were classified further into 2 groups, Dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (dengue hemorrhagic fever and/or dengue shock syndrome (DHF/DSS) according to WHO.Results: A total of 77 cases were classified into 67 (87%) non-severe and 10 (13%) severe dengue cases. The most common age of presentation was above 10 yrs. The mean age of admission was 8.9 yrs. The most common presenting symptom was fever seen in 93% followed by vomiting in 68%. Elevation in Aspartate transaminase (SGOT) and thrombocytopenia were found in 32.4 %.Conclusions: High grade fever, vomiting, abdominal pain and skin rash with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.


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 3 ◽  
pp. 44 ◽  
Author(s):  
Mary Dias ◽  
Chitra Pattabiraman ◽  
Shilpa Siddappa ◽  
Malali Gowda ◽  
Anita Shet ◽  
...  

Background: Mosquito-borne flaviviruses, such as dengue and Japanese encephalitis virus (JEV), cause life-threatening diseases, particularly in the tropics. Methods: Here we performed unbiased metagenomic sequencing of RNA extracted from the serum of four patients and the plasma of one patient, all hospitalized at a tertiary care centre in South India with severe or prolonged febrile illness, together with the serum from one healthy control, in 2014. Results: We identified and assembled a complete dengue virus type 3 sequence from a case of severe dengue fever. We also identified a small number of JEV sequences in the serum of two adults with febrile illness, including one with severe dengue. Phylogenetic analysis revealed that the dengue sequence belonged to genotype III. It has an estimated divergence time of 13.86 years from the most highly related Indian strains. In total, 11 amino acid substitutions were predicted for this strain in the antigenic envelope protein, when compared to the parent strain used for development of the first commercial dengue vaccine.  Conclusions: We demonstrate that both genome assembly and detection of a low number of viral sequences are possible through the unbiased sequencing of clinical material. These methods may help ascertain causal agents for febrile illnesses with no known cause.


2019 ◽  
Vol 6 (17) ◽  
pp. 1300-1305
Author(s):  
Mansi Singh ◽  
Ajay Kumar ◽  
Sanjay Mehrotra ◽  
Virendra Atam ◽  
Ravi Mishra ◽  
...  

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.


2021 ◽  
Vol 8 (35) ◽  
pp. 3247-3251
Author(s):  
Sreelatha Martha ◽  
Goutham Deeti ◽  
Chaitanya Jyothi Ravula ◽  
Nirmala Cherukuri ◽  
Srinivasa Suresh Nadavapalli

BACKGROUND Fever with thrombocytopenia is a common clinical problem in paediatric wards. Significant number of acute febrile illnesses have an infectious aetiology and are often associated with thrombocytopenia. The objective of the study was to determine the clinico-etiological profile and outcome of children admitted with febrile thrombocytopenia, especially in those with infective aetiology. METHODS The study design is a prospective observational study. It was conducted from September 2017 to August 2019 in the Department of Paediatrics, Niloufer Institute of Women and Child Health, Hyderabad. A total of hundred (100) children in the age group of 1 year to 12 years presented with fever, and thrombocytopenia were included in the study. Newborns, infants, children with febrile thrombocytopenia, known ITP (idiopathic thrombocytopenic purpura), already diagnosed haematological malignancy and children on antiplatelet drugs like aspirin were excluded from the study. After informed written consent, detailed history was elicited, clinical examination and necessary laboratory investigations were carried out, and the data was captured in a pre-structured proforma. Study parameters were analysed using Statistical Package for Social Sciences (SPSS) version 16 software. RESULTS The study included 100 children. A ratio of 1.4 : 1 was observed in male to female ratio. As of the clinical features, gastrointestinal (GI) symptoms such as nausea, vomiting and pain abdomen were more common, followed by headache and myalgia. On examination, two-thirds of the children had hepatomegaly, and onethird had splenomegaly. Among 100 children with febrile thrombocytopenia, 38 children had bleeding manifestations (cutaneous bleeds > GI bleeds > other bleeds) in those with moderate to severe thrombocytopenia. In the etiological profile, dengue fever was more common, followed by undiagnosed fever, enteric fever, ALL (acute lymphoblastic leukemia), scrub typhus, malaria and leptospira, respectively. Out of 100 children, 94 were discharged, and 6 children with ALL were referred to the haemato-oncology center for further management. CONCLUSIONS Clinical presentation of cases with febrile thrombocytopenia is varied. Common causes of febrile thrombocytopenia observed in this study were dengue fever followed by un diagnosed fever and enteric fever. KEYWORDS Fever, Thrombocytopenia, Platelet count, Bleeding


Author(s):  
Mohammed Fawas N. ◽  
Kadeeja Beevi B. ◽  
Balakrishnan Valliyot ◽  
Sudha Balakrishnan

Background: In the recent period there is an upsurge in the incidence of fever with thrombocytopenia in the Northern Kerala. This may be due to the several emerging and re emerging infections which causes frequent epidemics in the region. Early diagnosis and meticulous management will prevent fatal out come. Studies on fever with thrombocytopenia are very few in the Northern part of Kerala.Methods: This was a descriptive study conducted at Academy of Medical Sciences Pariyaram over a period of one year from November 2015 to October 2016. The study includes 251 cases attending outpatient and inpatients units in the department of medicine. All patients with a platelet count less than 150000 was included in this study and detailed clinical and laboratory evaluation was done and assessed for the etiology and outcome.Results: Among the 251 cases, Dengue fever accounts 54.5 % of cases and 26.2% are other viral fever where the exact causative organism was not detected. Leptospirosis, malaria were also important causes of fever with thrombocytopenia. Major incidence of hemorrhagic manifestation occurred in the age group of 20 to 30 years whose platelet count was in the range of 10000 to 40000/mm3.Conclusions: In this study more than 50 % had dengue fever and in 26.2% cases an exact etiology cannot be determined. This finding highlights the fact that there may be many unidentified infection which cause fulminant thrombocytopenia and there is a need for wider screening of infection. 


2017 ◽  
Vol 4 (6) ◽  
pp. 2012
Author(s):  
Hima Bindu Tirumani ◽  
Vinay Kumar Bejugam ◽  
Altaf Naseem ◽  
Arshad Hussain ◽  
. Nizarlalani

Background: Liver dysfunction in children is variable and depends on disease severity. This study was undertaken to identify the range of hepatic involvement in children with dengue infection.Methods: It is a cross sectional observational study conducted in serologically positive dengue fever in children aged between 1-14 years. Hepatic function was studied in all suspected cases over a period of 1 year from June 2015 to June 2016.Results: Out of 55 cases admitted, liver function tests showed AST levels elevated more than 45U/L in 20 (86.9%) DF, 29 (100%) DHF, 3 (100%) DSS patients. ALT levels were elevated more than 45U/L in 16 (69.5%) DF, 24 (82.75%) DHF, 3 (100%) DSS patients. More than 10 fold increase in levels of both AST and ALT was seen in severe dengue.Conclusions: Dengue infection is associated with variable levels of liver dysfunction. The incidence of hepatic dysfunction is more in patients with dengue fever with warning signs and severe dengue. Significant elevation of transaminase levels helps in predicting the occurrence of severe dengue. It is important to be aware of this entity which needs significant attention and management. 


2021 ◽  
Vol 11 (2) ◽  
pp. 341-353
Author(s):  
Suman Sarkar ◽  
Mamta Kumari ◽  
Amrita Roy ◽  
Anirban Chatterjee ◽  
Partha Pratim Pal

Dengue is an arboviral infection of public health problems in tropical and sub-tropical countries transmitted to humans through the bite of an infected mosquito of the Stegomyia family. It varies in severity, ranging from influenza-like self-limiting illness to life- threatening, which if left untreated, are associated with mortality as high as 20%. Find out hematological and coagulation profile in dengue infected children aged 1 to 12 years and association of hematological and coagulation profile with dengue severity. It is an Observational Cross- sectional study done on 100 dengue patients aged 1 to 12 years during the study period from March 2019 –February 2020. Among 100 dengue fever, 85 (85%) were categorized as dengue fever (DF), 11(11%) DF with warning signs and 4 (4%) were cases of severe dengue (DHF/DSS) according to revised World Health Organisation 2009. The most common age of presentation was above 6 years and females were afflicted more with dengue fever.100% dengue patients presented with fever. Persisting vomiting, pain abdomen, hepatomegaly and hypotension indicate progression towards severe dengue. Raised Hb% and PCV, low to normal values of WBC as well as predominantly decrease in platelet was seen in severe dengue cases however, both ESR and CRP were normal. The Liver function test was deranged SGOT>SGPT in almost all of the dengue patients and it was 3 to 4 times maximally in DFW and SD. PT, APTT prolongation, increased D- dimer and hypofibrinogenemia associated with the severity of dengue fever. Dengue is a common viral infection that may have serious consequences especially in children. There is clear difference in pattern of change of both haematological and biochemical parameters in non-severe dengue fever and severe dengue fever. Rising trend of Hb%, PCV, decreasing value of platelet count, raised transaminases (SGOT>SGPT), elevated D- dimer, PT and APTT and hypofibrinogenemia can be used as predictor of entry into critical phase


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