scholarly journals Clinical correlation of cardiac functions and troponin I and CPK-MB in dengue fever in children

2020 ◽  
Vol 7 (3) ◽  
pp. 576
Author(s):  
Devanand G. Chaudhary ◽  
Shyam Srinivasan ◽  
Nita R. Sutay

Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the World. The spectrum of manifestations includes mild fever to severe and life-threatening disease, though uncommon complications such as myocarditis have also been reported in many cases. We conducted this study to analyze association between Clinical Profile, Cardiac Functions and Troponin I and CPK-MB (cardiac biochemical markers) in children with Dengue Fever. Aims and objectives of the study was the association between Clinical Profile, Cardiac Functions and Troponin I and CPK-MB (cardiac biochemical markers) in children with Dengue Fever.Methods: This was a prospective observational study in which 80 paediatric patients who were hospitalized anddiagnosed to be having Dengue fever were included. All patients were stratified into either of the 3 groups- Dengue without warning signs, Dengue with warning signs and severe Dengue. A detailed history and thorough clinical examination were done for all patients. A complete blood count, electrolytes, hepatic and renal function tests were done in all children. Cardiac function was assessed by 2D Echo, CPK-MB and Troponin-I, p value less than 0.05 was taken as statistically significant.Results: Of the 80 studied cases there were 53 (66.25%) males and 27 (33.75%) females with a M:F ratio of 1.9:1. Dengue with and without warning signs was seen in 27.5% and 60% cases respectively whereas severe dengue was seen in 12.5% cases. The ejection fraction was comparable across the 3 groups. On 2D echo ejection fraction was 62.95%, 63.21% and 65.1% in cases with warning signs, without warning signs and severe dengue respectively. Additionally, ECG abnormalities were seen in 8.75% patients. All 80 patients had a normal CPK-MB and Troponin-I levels.Conclusions: Cardiac markers (CPK-MB and Troponin-I) remain unaffected during Dengue illness and do not have significant correlation between Dengue without warning signs, Dengue with warning signs and severe Dengue.

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.


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 (3) ◽  
pp. 1289
Author(s):  
V. G. Manjunath ◽  
Sruthi Balla ◽  
Jagadish Kumar

Background: Dengue fever (DF) is a major health problem, 90% of dengue hemorrhagic fever (DHF) occurring in children <5 years and mortality of 2.5%. Abnormalities like metabolic acidosis, hyponatremia and hypocalcemia can occur in severe dengue especially in dengue shock patients. Alterations in calcium homeostasis, may play a role in the pathogenesis of dengue shock. Objectives is to evaluate serum ionic calcium (Ca2+) levels in children aged 1-18yrs with dengue fever and correlate it with severity and outcomeMethods: The study was prospective hospital based case-control study. Case group had 75 children with dengue fever with equal number of controls. Cases were classified according to WHO classification. Serum Ca2+ levels were estimated within 24 hours of admission.Results: Majority of children with dengue were in the age-group of 6-15 years (71.4%). Out of 75 cases,16% were dengue without warning signs, 54.7% dengue with warning signs and 29.3% were severe dengue cases. Mean Ca2+ level (in mmol/l) was 1.2009 (±0.09) among controls and 1.0911 (±0.10) in dengue cases (p=0.0001). Mean Ca2+ level in dengue without warning signs was 1.0950 mmol/l, dengue with warning signs was 1.1088 mmol/l and severe dengue was 1.0559 mmol/l. Mean Ca2+ level in severe dengue was significantly lower compared to dengue with warning signs (p=0.04). Hypocalcemia was seen in 56% of dengue cases but only 14% among controls. Seven children with severe dengue who died had hypocalemia.Conclusions: Hypocalcemia is common in dengue fever. Lower levels of ionic calcium correlate with severity of dengue illness and may be considered as a prognostic indicator of poor outcome.


2021 ◽  
pp. 15-18
Author(s):  
Gaurav Choudhary ◽  
Yograj Khinchi ◽  
Chaman R Verma ◽  
Bhagwan Sahai Natani ◽  
Rakesh Bilwal ◽  
...  

Introduction: Dengue fever represents a signicant public health problem in tropical and subtropical regions. 70% of total cases are from Asia, especially India. Caused by 4 dengue virus serotypes( DENV-1, DENV-2 DENV-3 and DENV-4), DENV-2 being the most prevalent in India. Incidence and range of cardiac manifestations in dengue fever vary widely. Aims & objectives: To study the incidence and range of cardiac manifestations of dengue fever in children. Material & methods:This is an observational study, conducted in department of pediatrics at National Institute of Medical Sciences & Research, Jaipur in study period of 18 months. A total of 94 patients were included in the study fullling the inclusion criteria. Results: The overall incidence of cardiac manifestations was found to be 31.9%. The incidence of cardiac manifestations in dengue without warning signs was 4.4%, in dengue with warning signs was 52.5% and in severe dengue was 77.7%. Conclusion: Incidence of cardiac manifestations increases with increase in disease severity


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.


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.


2021 ◽  
pp. 41-43
Author(s):  
Manoj Kumar Ram ◽  
Bankey Bihari Singh

BACKGROUND & OBJECTIVES: Dengue illness has become exceedingly common over the last few years globally. Due to their unique characteristics, incidence as well as mortality is higher in pediatric population as compared to adults. This study was undertaken to study clinical pattern of dengue fever in children and to identify factors predicting a more severe disease. METHODS: We conducted this hospital based prospective study at A.N.M.M.C.H, Gaya, Bihar over 2 years from January 2016- December 2017. Children >1 month and <15 years age with fever ≥ 3 days and symptoms suggestive of Dengue infection were included and evaluated for dengue infection by testing for NS1 antigen, IgM and IgG against Dengue infection. Children were classied into 3 clinical groups: Dengue without warning signs (DWWS), Dengue with warning signs (DWS) and severe Dengue (SD) as per WHO classication. Clinical and laboratory parameters were compared in the 3 groups. RESULTS: 114 children with Dengue were studied. 62 (54.4%) were males as compared to 52 (45.6%) females. 41 (36%) had DWWS, 53 (46.5%) had DWS and 20 (17.5%) had SD. Mean age was 74.1 months (SD 18.2 months) and mean weight was 21.4 kg (S.D 5.1 kg). Common symptoms were fever (100%), myalgia (76.6%), chills (62.3%), nausea/ vomiting (63.2%) and rash (53.5%). Common signs were ushed appearance (36.8%), positive Hess test (27.2%), bleeding manifestation (13.2%) and hypotension (36.8%). Laboratory investigations revealed anaemia (18.4%), thrombocytopenia (81.6%), Leucopenia (69.3%), elevated transaminase (41.2%), abnormal RFT (5.3%). 27.1% had prolonged aPTT while 21% had prolonged PT. Nausea/vomiting, bleeding, oliguria, capillary leak and liver enlargement (>2 cm) were signicantly more common in severe dengue (p<0.05) whereas rash was commoner in non severe dengue. Lab parameters signicantly more common in SD included rising hematocrit, falling platelets, high urea/creatinine/ALT and hypoalbuminemia & hypocholesterolemia. CONCLUSIONS: DF affects children irrespective of age. Symptoms more common in SD were nausea/vomiting, bleeding and decreased urine. Signs commoner in SD were features of capillary leak and hepatomegaly (>2 cm). Rising hematocrit, falling platelets, high urea, creatinine and ALT but hypoalbuminemia and low cholesterol were found to be statistically signicant laboratory parameters associated with SD.


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.


2017 ◽  
Vol 03 (02) ◽  
pp. E76-E81 ◽  
Author(s):  
Jitendra Parmar ◽  
Chander Mohan ◽  
Maulik Vora

Abstract Background Dengue fever is a major public health problem with an increased incidence in recent years. Gall bladder wall thickening has been reported as one of the most common findings in dengue fever. There is a paucity of literature regarding the various patterns of gall bladder wall thickening in dengue fever and their significance in predicting the severity of disease. Methodology and Significant Findings Out of 93 seropositive patients included in the study, 54 patients with dengue fever had gall bladder wall thickening. 4 patterns of gall bladder wall thickening are demonstrated in this study. A uniform echogenic pattern in 20 patients, striated or tram track pattern in 11 patients, an asymmetric pattern in 2 patients and a honeycombing pattern in 21 patients. The range of patterns of wall thickening included normal wall thickening or uniform echogenic wall thickening in DF without warning signs, a striated or tram track pattern, and a honeycomb pattern in severe DF. Serial ultrasound done on consecutive alternate days revealed a change in the pattern of gall bladder wall thickening according to the severity of disease. Conclusion The present study revealed 4 distinct patterns of gall bladder wall thickening. The uniform echogenic pattern was found to be more prevalent in dengue fever without warning signs, while the honeycomb pattern was found to be more prevalent in severe dengue fever. A change in the pattern of gall bladder wall thickening on subsequent serial ultrasound can predict the severity of the disease.


Sign in / Sign up

Export Citation Format

Share Document