scholarly journals Clinicohaematological profile of dengue in children: a hospital based study

2017 ◽  
Vol 4 (4) ◽  
pp. 1340 ◽  
Author(s):  
Irshad Abdul Majeed ◽  
K. Shreedhara Avabratha ◽  
Lokesha R. Gowda ◽  
Sadia Syeda

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. The aim of this study is to document varied clinical manifestations and haematological parameters of dengue patients in a tertiary care centre.Methods: A total 130 cases of any of NS1 antigen, IgM card test positive or IgM ELISA positive dengue patients were included in this observational study. Clinical and haematological parameters were noted and analysed statistically.Results: Most common clinical feature was fever (100%) followed by headache (51.5%). Atypical features like seizures due to encephalitis was seen in a child with dengue. Seizure were present in 1.5% of cases, two children died due to severe dengue with shock and multi organ failure. In our study 26.92% of patients had thrombocytopenia. The mean Hb was 12.86 g/dl and platelet count was 104202/mm3.Conclusions: Fever and headache are the main features of dengue. However, one should be aware of different atypical presentations of dengue fever to diagnose and intervene timely. Early recognition of complication and timely intervention are required in the management of dengue cases. 

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.


2019 ◽  
Vol 6 (5) ◽  
pp. 1447
Author(s):  
Katari Sujitha ◽  
M. Dorasanamm ◽  
M. V. Nagabhushana

Background: Dengue fever is one of the most common acute viral illness associated with considerable morbidity and mortality. Recently, there is an alarming rise of dengue in India. This study was undertaken to know the clinical profile and laboratory findings during the evolution of dengue fever.Methods: A total of 120 patients of dengue fever who were NS1 antigen or IgM dengue positive, admitted to medical wards of Narayana Medical College, Nellore included in the study. Thorough clinical examination and relevant laboratory investigations performed in all patientsResults: Males were commonly affected (72.4%). Fever was the most common presentation (100%), followed by headache (96%) myalgia (94%), abdominal pain (24.46%), and retro-orbital pain (12.45%). Malena was the most common hemorrhagic manifestation. Laboratory findings include varying degree of thrombocytopenia in all patients, leukocytopenia (30.52%), increased hematocrit (>45%) (67.59%) and deranged liver function test (58.33%)Conclusions: Early diagnosis, monitoring, and prompt supportive management can reduce mortality in dengue. Atypical presentations of dengue should be kept in mind, which may cause a delay in the diagnosis. Increased community awareness and vector control measures need to be strengthened during the peri-monsoon period to reduce the burden of dengue cases.


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.


2020 ◽  
Vol 7 (2) ◽  
pp. 382 ◽  
Author(s):  
V. Shekar ◽  
K. Praveen Kumar ◽  
C. Soren ◽  
K. Venkataramana Reddy ◽  
N. Dharani

Background: Dengue is a self-limiting, vector-borne disease transmitted by Aedes mosquito, causing a major public health threat globally. The objective of this study is to assess the clinical profile and outcome of the dengue infection in children less than 14 years of age September 2018 to August 2019 at the Pediatric Department of S.V.S. Medical College, the tertiary care hospital in Mahabubnagar, Telanagana.Methods: Prospective study of 82 hospitalized children of <14 years with the diagnosis of dengue illness. Children with diagnosis of dengue were classified further in to two groups as per WHO guidelines, Non-severe dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (Dengue Haemorrhagic Fever and/or Dengue Shock Syndrome (DHF/DSS). A separate questionnaire form used for documenting clinical history, laboratory parameters. Haematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done. Children were managed as per WHO protocol. The outcomes of the cases were mentioned as discharge, left against medical advice and death.Results: A total of 82 children with dengue were divided in to 55(67%) non severe dengue and 27(33%) severe dengue with males 56(68.2%) and females 26(31.7%). The most common age of presentation was between 6-10 years 34(41.5%). Fever 73(89%) was the most common presenting symptoms. Pleural effusion and hepatomegaly were the commonest clinical findings 28(34.1%) each, which were more among the severe dengue patients. Gall bladder edema 29(35.3%) was the most common ultra-sonogram finding. Significant elevation of transaminases (SGOP, SGPT) was seen in 39(47.5%). Severe thrombocytopenia was observed in 22(26.8%) children. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a global problem. Presenting features include high grade fever, vomiting, abdominal pain, skin rash. Early recognition of symptoms and proper management can reduce the mortality.


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.


Author(s):  
Sangeetha Jairaj ◽  
Sridhar D. ◽  
Mettu Pradeep Reddy

Background: Dengue is found in tropical and subtropical regions around the world, predominantly in urban and semi-urban areas. Dengue mortality can be reduced by implementing early case detection and referral systems for patients; managing severe cases with appropriate treatment; reorienting health services to cope with dengue outbreaks; and training health personnel at all levels of the health system. Many studies that focus on the difference between the frequency of clinical findings in DHF and dengue shock syndrome (DSS) with respect to classical DF has been published. The objectives of the study were to assess signs and symptoms of dengue among patients with severe dengue and patients with dengue fever and to evaluate laboratory and radiological profile among dengue patients.Methods: This Hospital based cross sectional study was conducted on 70 seropositive cases, admitted in the Paediatrics Department of Gandhi hospital during the period of July to December 2017 for 6months. Data was analyzed by using SPPS Version 17 and student t test was used for inferential statistics.Results: Out of 70 cases 38 were presented with severe dengue and 32 presented with dengue fever. Average age of presentation is 7.24 years among severe dengue group, 5.52 years among dengue fever group. In group of severe dengue, 60.5% of the cases were female, which was insignificantly more as compared to 40.6% of the cases from group of dengue fever.Conclusions: All levels of health personnel must be aware of clinical signs and symptoms of all dengue types. Careful monitoring of unusual presentations early recognition severe manifestation and timely intervention can reduce disease specific mortality rate.


2021 ◽  
Vol 8 (5) ◽  
pp. 839
Author(s):  
Priyasha Tripathi ◽  
Priya Gogia ◽  
Surendra Singh Raghuwanshi

Background: Mortality due to dengue fever during epidemics is very high with all the four serotypes actively found in India. It is very difficult to distinguish and manage illness of viral aetiologies based on initial clinical features. Bradycardia can be seen as notable clinical finding in severe dengue fever. Clinical features that can be used in the initial assessment of febrile patients are essential tools for physicians in limited resource settings. Awareness of bradycardia as an early indicator of severe dengue fever could help in the early recognition and potentially reduce morbidity and mortality.Methods: This is an observational comparative study of 40 dengue fever positive paediatric patients admitted in PICU and general ward. The study was conducted at Atal Bihar Vajpayee Govt Medical College, Vidisha from 20 August to 20 November 2020 (3 months).Results: Bradycardia, as a significant clinical feature was present in almost all PICU patients as compared to ward patients. It can be taken as a clinical marker of severity to prevent life threatening complications of dengue like shock and haemorrhage.Conclusions: With specific WHO guidelines to classify and treat dengue fever, we try to prevent its deadly consequences but in resource limited settings like ours, initial clinical judgement can prevent much causality and prepare us to foresee and timely manage the complications.


2019 ◽  
Vol 6 (3) ◽  
pp. 1194
Author(s):  
Belgin Premkumar ◽  
Baburaj S. ◽  
Margaret Hepzibah N. ◽  
Misha K. P. ◽  
Binu Abraham

Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world.Incidence has increased 230-fold with increasing geographic expansion with potential for further spread. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden. This study’s objective is to assess the outbreak of epidemic of dengue fever in a tertiary care children hospital and to describe their socio-demographic, clinical outcome and serological profile.Methods: It is an observational descriptive study conducted for a period of 1 year in less than 12 years old children in a tertiary care hospital at Southern Tamil Nadu.Results: Among the 360 children admitted with dengue fever, there were 198 boys (55%) and 162 (45%) were girls. Maximum incidence of dengue incidence was seen in infants less than 1 year (25%). The highest number of cases were admitted during September and October. The most common affected age group was less than 3 years with 179 (49%). Among the cases, 297 (82%) were of severe dengue which constitute dengue haemorrhagic fever-183(38%) and Dengue shock syndrome 114 (62%). Serological analysis showed NS1 Ag was positive in 144 children (40%), Dengue IgM was positive in 54 children (15%), both IgM and IgG positive in 126 children (35%) and IgG was positive in 36 children (10%). Out of the total children admitted with dengue fever, the case fatality was 0.5% (2 children).Conclusions: This study highlights the importance of WHO clinical criteria for early diagnosis of severe dengue. Moreover, the early and intensive management reduces the mortality significantly.


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.


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