scholarly journals Clinical profile of dengue fever in children presented at a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 761
Author(s):  
Senthilkumar K. M. ◽  
Hema Harini R.

Background: Dengue fever is a benign syndrome caused by an arthropod-borne virus and is characterized by Biphasic fever, myalgia, and arthralgia, rash, leucopenia, and lymphadenopathy. Dengue hemorrhagic fever and dengue shock syndrome are a severe, often fatal febrile disease caused by 1 of 4 dengue virus. It is characterized by increased capillary permeability, abnormalities of hemostasis and protein-losing shock syndrome. The aim of this study was to assess the clinical profile, complications and outcome of dengue infection in children.Methods: All children attending the hospital with symptoms and signs suggestive of dengue fever were tested for NS1 antigen and IgM/ IgG dengue antibody serology (depending on the day of fever) by enzyme-linked immunosorbent assay (ELISA) technique.Results: Of the 174-dengue serology positive children, fever was the most common major symptom (97.7%) followed by vomiting (85.6%), loss of appetite (81.6%), abdominal pain (77%), body pain/leg pain (62.6%). Severe dengue as per WHO criteria was seen in 29 (16.7%) children. Thrombocytopenia (platelet count less 1,00,000) was observed in 82 children (47%), Platelet count less than 20,000 in 8 children (4.5%). Dengue shock syndrome was seen it 26 children (15%). Mortality was nil.Conclusions: In children, if symptoms like fever, vomiting, loss of appetite, abdominal pain and body pain are present, a strong possibility of dengue fever is present especially in an epidemic setting. Early suspicion and effective management can reduce the severity.

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.


Author(s):  
Pooja Gandhi ◽  
Pinkal Taral ◽  
Krunal Patel ◽  
Sanketsinh Rathod ◽  
Bhavini Rathwa

Introduction: Infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock. Given that dengue virus infection elicits such a broad range of clinical symptoms, early and accurate laboratory diagnosis is essential for appropriate patient management. So a study was carried out to know its clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients. Aim: To study the clinical profile, correlation between the laboratory profile and the severity of dengue fever and outcome in dengue patients at tertiary care center. Method: Retrospective Observational study from 1st May 2019 to 31st April 2021. Result: Total 323 patients were studied during 1st May 2019 to 31st April 2021. Most common presentation was fever (100%), most common clinical finding is hepatomegaly (14.2%). All severe dengue infection has platelet count < 50000/cumm. In study of 323 patients 194(60%) of dengue fever,85(26.4%) of DHF GRADE 1,9(2.8%) of DHF GRADE 2 were discharged .13(4%) patients of DSS were expired.22 patients (6.8%) went DAMA. Conclusion: Reliable diagnosis of dengue fever in endemic areas can be done by clinical parameters like presence of nausea, vomiting, pain abdomen and hepatomegaly. Monitoring platelet count, hematocrit and WBC count is very useful for management of dengue cases. Keywords: dengue fever, platelet count, outcome


Author(s):  
Chilakala Padmavathy ◽  
B. Devi Madhavi ◽  
S. Suneetha ◽  
Suresh Babu Chaduvula

Background: Dengue is a mosquito borne viral disease in the world with unpredictable clinical course and outcome. Though it is self-limiting in most of patients, the dengue hemorrhagic stage and dengue shock syndrome are life threatening.Methods: It is a retrospective cross-sectional observational record-based study conducted in King George Hospital in Andhra Medical College, Visakhapatnam, AP, India. Upon clinical suspicion, Dengue fever was confirmed by NS 1 antigen and/or Dengue antibody IgM, IgG in KGH laboratory in patients who were admitted in the hospital data was collected from records after ethical committee approval. Data of pediatric dengue positive cases in the age group ranging between 0-14 years from January 2018 - November 2018 were reviewed.Results: In this study the highest percentage of age group was found between 0-5 years. Fever was present in 100% cases, abdominal pain in 47% cases, rash, nausea/vomiting were found in 37%, headache in 12.35%, myalgia/ arthralgia or backache in 13.48%, retro orbital pain in <1% cases. Dengue fever (DF) was found in 46 % cases, dengue hemorrhagic fever (DHF) in 50% and dengue shock syndrome (DSS) in 3.9 cases.Conclusions: The study found among these 50% developed DHF and 46% DF and 3.9% DSS. Early admissions of pediatric cases can prevent major complications like DHF and DSS. The predominant complaints found were fever, vomiting and abdominal pain in paediatric group.


2021 ◽  
Vol 44 (2) ◽  
pp. 74-77
Author(s):  
Farhana Rahat ◽  
Morsheda Khanam ◽  
Kazi Iman ◽  
UK Ghosh ◽  
NK Ghosh

Background: Dengue fever has become one of the most important public health concerns now a day due to increasing complications and fatal outcomes. Dengue hemorrhagic fever and dengue shock syndrome are life threatening but reversible complications of dengue fever. Objectives: This study was performed to evaluate the relationship between platelet count and hematocrit with the severity of dengue infection in pediatric age group. Materials & Methods: This was a prospective observational study which included 280 dengue seropositive children of 1 month to 15 years, conducted during 1st June to 30th November, 2018 in a tertiary care hospital of Dhaka. Results: Out of 280 dengue cases, 187(66.78%) had thrombocytopenia and 88(47%) had raised hematocrit. Among the thrombocytopenic patients 44% had dengue fever, 47% had dengue hemorrhagic fever and 9% dengue shock syndrome. A significant co-relation was observed between the severities of thrombocytopenia and raised hematocrit with the appearance of dengue warning signs in case of dengue hemorrhagic fever. Conclusion: Thrombocytopenia and raised hematocrit were related to the severity of dengue hemorrhagic fever. Bangladesh J Child Health 2020; VOL 44 (2) :74-77


Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Shubhankar Mishra ◽  
Ramya Ramanathan ◽  
Sunil Kumar Agarwalla

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.Objectives. To assess the clinical profile of the dengue infection in children less than 14 years of age and to evaluate the outcomes of dengue fever from September 2013 to August 2015 at the Pediatric Department of Maharaja Krishna Chandra Gajapati Medical College, the largest tertiary care hospital of southern Odisha.Results. A total of 97 cases were classified into 84 (86.59%) nonsevere and 13 (13.40%) severe dengue cases. The most common age of presentation was above 11 yrs. The mean age of admission was 8.7 yrs. The most common presenting symptom was fever seen in 100% and hepatomegaly (43.8%), the most common physical finding. Gastrointestinal bleeding was markedly seen in severe dengue (76.9%). Elevation in aspartate transaminase (SGOT) was found in 47.42% and thrombocytopenia in 27.5%. The correlation between hepatomegaly and elevated SGOT was significant (Pvalue 0.0346). Case fatality rate (CFR) was 1.03%. The mean duration of hospitalisation was 3.8 days.Conclusion. In children, if symptoms like fever, pain, rashes, and vomiting are associated with hepatomegaly and elevated SGOT in context of low TPC, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.


2020 ◽  
pp. 15-19
Author(s):  
Udaya Kumar Neelagiri

Background: In the past few decades the incidence, distribution, and clinical severity of Dengue have increased dramatically. Population growth in the tropics provides many susceptible hosts. Uncontrolled urbanization leads to inadequate management of water and waste, providing a range of large water stores and disposable, non-biodegradable containers that become habitats for the larvae. Children are now being increasingly affected by this disease. We in this present study tried to study clinical, hematological, and hepatic dysfunction in the early course of the disease. Methods: The present prospective observational study was conducted at Prathima Institute of Medical Sciences, Nagnur, Karimnagar. N=75 children between the age group of 6 months to 15 yrs presenting with symptoms and signs suggestive of dengue fever as per WHO criteria were included in the study. Complete history and clinical examination were done. Investigations were performed as per the proforma. Results: From n=75 children n=56 (75%) belongs to dengue with warning signs and severe dengue whereas n=19 cases (25%) belong to mild dengue group. the symptoms recorded out of n=75 (100%) children presented with fever as the predominant complaint followed by vomiting (49%), Retroorbital pain (28%), Abdominal pain (26%), Edema (25%), Bleeding (19%) and rashes (12%), body ache (8%). The range of platelet count at admission was 4,000 – 98,000/cmm, with a mean value of 53,000 (P>0.05). The WHO criteria of a low platelet count of < 100,000/cmm were seen in all cases (100%). Conclusion: in children, importance should be given to symptoms like fever, vomiting, bleeding, musculoskeletal pain, flushing, and abdominal pain. If these are associated with hepatomegaly, positive tourniquet test, low platelet count, and elevated liver enzymes, a strong possibility of dengue to be considered, especially during an epidemic. During the epidemic, dengue should be considered on the differential diagnosis of any child presenting with fever


2021 ◽  
Vol 8 (4) ◽  
pp. 631
Author(s):  
S. V. S. Sreedhar ◽  
Ramishetty M. Umamahesh

Background: Dengue viral infection is the most common mosquito-borne disease in the world with varied presentations, high morbidity, and high mortality patterns. To study the clinical profile and outcome of dengue fever in children.  Methods: This analytical study was conducted in children less than 12 years of age with clinical features of dengue (any acute febrile illness with one of the following: myalgia, headache, retro-orbital pain, bleeding, altered sensorium, shock, or low platelet count) presented at Mahavir institute of medical sciences between February 2019 to January 2020 (12) months were included in the study. Children positive for IgM alone or both IgM and IgG were followed up for a clinical profile.Results: Seizures (9.5%), loose stools (8.5%), lymphadenopathy (15.2%), relative bradycardia (8.5%) were less common manifestations. Rashes were seen in 64.7% of children. Many children in this study were mildly anemic. Mean hemoglobin was slightly higher in dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Mean Hb in DSS was 11.28 g%. It was 10.02, 10.1, and 10.45 in DF, DFB, DHF respectively. But it was statistically not significant (P=0.27).Conclusions: Seizure was significant in DSS cases. Any dengue child throwing convulsions should hence be promptly evaluated for an unrecognized shock. The bleeding in dengue is not purely due to thrombocytopenia. There is no role for prophylactic platelet transfusion.


2020 ◽  
Vol 7 (8) ◽  
pp. 1670
Author(s):  
Poornima Shankar ◽  
Shajna Mahamud

Background: Dengue, an endemic disease in most subtropical and tropical regions of the world is causing severe epidemics in India. An alarming rise of dengue has also been seen in India during the recent years. Majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. Present study was undertaken with an objective of describing various clinical presentations as noted in our cohort of dengue patients and to evaluate the outcome of dengue fever.Methods: This retrospective study included all confirmed dengue cases below 18 years age admitted to Paediatric department of KIMS, Bengaluru over a period of 1 year in 2019. Medical records were reviewed and analysed. Those diagnosed to be positive for dengue serology (NS1 or IgM) were included in our study. Dengue was classified according to the WHO guidelines into 2 groups, Dengue fever (without/with warning signs) and Severe Dengue. Clinical features, haematological, biochemical, radiological parameters, management and the outcome were assessed.Results: Out of 441 patients enrolled, 79% had non-severe dengue and 21% severe dengue. The commonest age of presentation was above 10 years with mean age of 8.68±5.25 years. Male to female ratio was 1.7:1. 60% presented within 4 to 7 days of illness (mean 4.26±1.72 days). Majority presented with fever (88%). 47% had vomiting and 31% abdominal pain. Bleeding manifestations were seen in 18%. Dengue serology was positive for NS1Ag (58%), IgM (21%), mixed (21%). Thrombocytopenia and leukopenia seen in 82% and 39.45% respectively. The association between dengue serology and platelet count was statistically significant (p value 0.001). 46% had raised SGPT. 31% had evidence of plasma leakage. The case fatality rate was 0.2%.Conclusions: High grade fever, vomiting, abdominal pain and bleeding manifestations with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.


2018 ◽  
Vol 5 (1) ◽  
pp. 137
Author(s):  
Jahnavi K. ◽  
Srinivasulu T.

Background: Dengue is endemic in India and epidemics are common. Due to poor availability of resources, there is increased morbidity and mortality related to dengue. The objective of the research to study the incidence, manifestations and complications of dengue fever.Methods: Patients admitted in medicine wards of a tertiary care hospital during the study period of two years with the history of fever with other nonspecific symptoms were included in the present study. Data was collected in a pre-tested proforma by meeting objectives of the present study. 100 patients who fulfilled World Health Organization criteria for dengue fever were selected by simple random sampling method.Results: In 75 patients the platelet count was above 150000cell/cumm. Most of them had dengue fever. 12 patients showed platelet count between 20000-100000cells/cumm. and among them 10 were DHF and 2 were simple dengue infection. Five patients showed platelet count less than 20000cells/cumm. and among them 2 were DHF and 3 were DSS. Most of the bleeding skin manifestations were seen when platelet count was below 50000cells/cumm. Mucosal bleeding was observed when the platelet count was below 30000cells/cumm. Abnormal coagulation profile was noted in 18% of the patients and 6% patients were in acute renal failure. Mortality was 0% in dengue fever, 44% in DHF and 100% in DSS.Conclusions: Platelet count was directly related to the number of complications. Dengue shock syndrome and dengue hemorrhagic fever was associated with increased mortality.


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