scholarly journals Clinical profile and outcome of dengue fever among children in tertiary care hospital

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.

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 10 (1) ◽  
pp. e2018021 ◽  
Author(s):  
Vishal Vishnu Tewari ◽  
Kunal Tewari ◽  
Ritu Mehta

AbstractBackground: Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional burden on hospitals, necessitating bolstering of services in the emergency department, laboratory with creation of additional dengue fever wards.Objectives: To study the clinical and hematological profile of dengue fever cases presenting to a hospital.Methods: Patients with fever and other signs of dengue with either positive NS1 antigen test or IgM or IgG antibody were included. Age, gender, clinical presentation, platelet count and hematocrit were noted and patients classified as dengue fever (DF), dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Duration of hospitalization, bleeding manifestations, requirement for platelet component support and mortality were recorded.Results: There were 443 adults and 57 children between 6 months to 77 year age. NS1 was positive in 115 patients (23%). Fever (99.8%) and severe bodyache (97.4%) were the commonest presentation. DF was seen in 484 (96.8 %), DHF in 10 (2%) and DSS in 6 cases (1.2%). OPD treatment was needed in 412 (82%) and hospitalization in 88 (18%). Intravenous fluid resuscitation was needed in 16 (3.2%) patients. Thrombocytopenia was seen in 335 (67%) patients at presentation. Platelet transfusion was needed in 46 (9.2%). PRC transfusion was given in 3 patients with DF and 10 of DHF. Death occurred in 03 DSS and 2 DHF patients. Conclusions: Majority of DF cases can be managed on OPD basis. DHF and DSS carry high mortality. Hospitals can analyze annual data for resource allocation for capacity expansion.


2013 ◽  
Vol 5 (1) ◽  
pp. e2013014 ◽  
Author(s):  
Muhammad Imran Hasan Khan ◽  
Eram Anwar ◽  
Adnan Agha ◽  
Noha Saleh ◽  
Ehsan Ullah ◽  
...  

Introduction: Dengue virus (DENV) affects over half the world’s population in 112 countries, and dengue fever (DF) is the second largest arthropod borne infectious global hazard after malaria with complications like Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) accounting for significant morbidity and mortality world over. Pakistan is significantly affected with DENV infection and to-date no study identifying risk factors associated with complications of DF has been done. Methods: 997 confirmed cases of DF were collected in a tertiary care hospital in Lahore, Pakistan and their clinical and biochemical data were collected. Univariate, multivariate and logistics regression analysis was performed to identify risk factors associated with development of DHF and DSS. Results: Bleeding OR 70.7 (CI 38.4-129.9), deranged liver function test OR 1.9 (CI 0.97-0.99), platelet count on admission less than 50,000 x109/L OR 0.16 (CI 0.13-0.19), presence of urinary red blood cells OR 1.4 (CI 0.179-0.900) and presence of urinary protein OR 1.1 (CI 0.191-0.974) were related to development of DHF and DSS.


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


Author(s):  
Ramesan K. ◽  
Ajith Kumar M. K. ◽  
Balakrishnan Valliyot ◽  
Sudha Balakrishnan

Background: Dengue fever is the most common arboviral disease and fifty percent of world population is at risk. Frequent outbreaks are reported from all states of our country and incidence increases every year. This case study is of 305 patients from Academy of Medical Sciences, which is a tertiary care centre and research Institute in North Kerala. The objective of this study was to study the clinical profile of dengue fever.Methods: Study was prospective observational study conducted during the epidemic for a period of one year. All the cases which fulfilled WHO criteria for diagnosis of dengue fever and those who are positive for IGM antibody detected by enzymelinked immunosorbent assay (IgM ELISA) were only included in this study.Results: There is male preponderance, and those above the age of 30 years affected more. All patients had fever. Gastrointestinal manifestation like nausea and vomiting were commonly observed symptoms. Hepatomegaly, rash and conjuctival suffusion were important physical findings, whereas splenomegaly noted only in 8.2% cases. Thrombocytopenia is noticed in 73.96%.Conclusions: The mortality is 2.6%. Hypotension and thrombocytopenia are the two important determinants of mortality. Dengue Shock syndrome and Dengue Hemorrhagic Fever were relatively less when compared to other epidemics from different regions.


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.


2019 ◽  
Vol 6 (5) ◽  
pp. 1554
Author(s):  
Srikant Kumar Dhar ◽  
Swati Samant ◽  
Pramod Kumar Tudu ◽  
Debasmita Tripathy ◽  
Vujwal Roy K. ◽  
...  

Background: Dengue is a vector borne disease by four different serotypes of dengue virus transmitted by bite of female Aedes mosquito. It is an acute febrile illness characterised by myalgia, joint pain, gastrointestinal manifestations. Complications like dengue hemorrhagic fever (DHF) and Dengue shock syndrome (DSS) , Extended Dengue Syndrome(EDS) may be fatal for patients. Authors analyse different clinical spectrum of of manifestations, complications and correlation bleeding to platelet level.Methods: This study conducted from July 2017 to December 2018 comprising of 100 dengue patients of age more than 15 years in IMS & SUM Hospital.Result: Out of 100 dengue patients’ males 73% and females 27%. From the patients 57% were NS1 Antigen positive, 29% IgM positive, 9% NS1 and IgM positive, 4% IgM and IgG positive and 2 % with all NS1, IgM, IgG positive. In our series in clinical manifestations, all cases (100%) presented with fever, myalgia (78%), headache (53%), rashes (14%), nausea, pain abdomen (21%) loose motion (17%), and Retro-orbital pain (6%). Bleeding manifestations in any form was seen in 39% cases like Purpura or Petechie (23%), malena (18%), hematemesis ( 2% ), epixtasis (6%), Gum bleeding (2%), Hematuria (1%), and Ophthalmic bleeding like sub conjunctival hemorrhage, intra-vitreal hemorrhage in 8% cases. Complications detected e.g. hepatopathy in 53%, nephropathy. 4%, ascites 8%, pneumonia 7%, DSS (4%), Multi Organ Dysfunction (MODS) (4%), DHF (8%) and EDS in 2% cases. It was observed that 95.8% of patients with platelet counts between 20,000-50,000/cu.mm and 61% of patients less than 25000 had bleeding manifestations.Conclusion: Wide clinical spectrum of manifestations and complications makes it common differential diagnosis of acute febrile illnesses and bleeding manifestation does not always corelate with lower platelet count.


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.


2020 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
P. Leela Kumari

Background: Among all flaviviruses, Dengue is the most common fever. Every year 2-5 lakh cases of Dengue hemorrhagic fever occur. The objective of the study was to evaluate the clinical profile of patients with Dengue fever at a hospital in Kerala. Subjects and Methods: Patients with more than 12 years of age and those admitted with fever, headache, and myalgia were assessed with other clinical characteristics (warning signs of dengue fever, signs of hemorrhage, signs of plasma leakage and signs of shock). Laboratory examinations such as Hb, total count, differential count, platelet count, packed cell volume, peripheral smear for the malarial parasite, and liver function test (including S. protein) and renal function test were carried out. Blood coagulation profiles such as Bleeding Time, Clotting Time, Prothrombin Time and aPTT were performed. Radiological findings like X-ray chest and USG abdomen were also performed. Results: Consequently dengue fever is ordinary in young adults. In the current study, males were more pretentious than females. Males were affected by 63.7% while females are affected by 36.3%. The most usual indication was fever (94.8%) experienced in all patients followed by headache (41.3%), Generalized weakness (77.5%), myalgia (51.7%), vomiting (57.7%). Predominant organ involvement was hepatic (transaminases, jaundice) followed by gastrointestinal (abdominal pain, distension, loose stools, vomiting, ascites) systems. The total survivors are 86(74.1%) whereas 30(25.8%) were non-survivors. Conclusion: Dengue fever usually affects male and young populace. Headache, fever, myalgia are ordinary at hand grumble however in the recent few years, the world has observed the diverse experimental appearance of the dengue fever in dissimilar epidemics, even in the same regions and even with the period of times.


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