scholarly journals Clinical spectrum of dengue at a tertiary care hospital in Eastern India

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 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.


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.


2021 ◽  
Vol 6 (2) ◽  
pp. 25-36
Author(s):  
Samrat Biswas ◽  
Jyoti Hazarika ◽  
Mihirjyoti Pathak

Dengue virus (DENV) has rapidly expanded its range through tropical and subtropical regions in recent years. This pathogen causes acute febrile illness (dengue fever, DF) and severe bleeding disease (dengue hemorrhagic fever, DHF) in humans. In this study we are trying to analyze the data obtained from the diagnosis conducted upon the Dengue suspected patients visiting tertiary care hospital, Sonitpur, Assam and to give a scientific evaluation to the pattern or spread of this epidemic disease. A total of 361 serum samples are analysed from suspected dengue cases during this study period. This study basically gives our research team to go more investigating the dengue viral expansion in coming days as we were able to discriminate among the patients on the basis of primary and secondary infections, what they were previously not examined for. Significant clue for the presence of secondary dengue viral infections (17.3%) among 10 different districts is found. Keywords: Dengue, Viral Research and Diagnostic Laboratory (VRDL), Tezpur Medical College & Hospital (TMCH).


2020 ◽  
Vol 7 (5) ◽  
pp. 825
Author(s):  
Kausik Munsi ◽  
Sayonee Das ◽  
Ramiz Islam ◽  
Parvez Shahide Biswas ◽  
Satyabrata Ganguly ◽  
...  

Background: Authors aimed to identify incidence of scrub typhus among patients of fever. Scrub typhus is an endemic disease in India caused by Orientia tsutsugamushi, transmitted by trombiculid mites. It is an important cause of acute febrile illness in India. Signs and symptoms include fever, headache, myalgia and GI symptoms and is generally associated with morbilliform rash (<40%), eschar (<50%) which is due to bite of the mite. Abnormal LFTs and lymphocytosis are commonly seen in early phase of illness. It’s often labelled as PUO. Early diagnosis and prompt administration of therapy mostly leads to complete recoveryMethods: Authors screened 100 patients presenting with fever, malaise, headache, with or without rash for more than a week from the month of May to December 2019. Routine blood investigations with fever profile (Dengue NS1 antigen, MP, MPDA, TyphidotM) and cultures were done. Patients in whom no cause of fever could be established, having lymphocytosis, hyponatremia and transaminitis, they were tested for Scrub typhus by using Indirect immunofluorescence & detection of IgM antibody.Results: Total 22 patients were found positive for scrub typhus by using the aforementioned method (22%). Male: Female ratio was 3:4 (9 vs 12). Patients were in the age group of 16-76 years. Lymphocytosis, hyponatremia and transaminitis were cardinal features seen in almost all patients diagnosed with Scrub Typhus.Conclusions: This study will help clinicians to have a stronger suspicion of scrub typhus in undiagnosed febrile patients.


2016 ◽  
Vol 8 (4) ◽  
pp. 147 ◽  
Author(s):  
KundavaramPaul Prabhakar Abhilash ◽  
JonathanArul Jeevan ◽  
Shubhanker Mitra ◽  
Nirvin Paul ◽  
ThimiriPalani Murugan ◽  
...  

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


2018 ◽  
Vol 7 (1) ◽  
pp. 1582 ◽  
Author(s):  
Liza Goswami ◽  
Chowdhury Runumi ◽  
Elmy S. Rasul

<p><strong>Background:</strong> Dengue fever (DF) and dengue hemorrhagic fever (DHF) are important arthropod borne viral diseases. Dengue in India has dramatically expanded over the last few decades, with rapidly changing epidemiology. Dengue is emerging as major public health concern in northeast India and spreading with increased morbidity.</p><p><strong>Objective:</strong>This study was carried out to determine the seroprevalence of Dengue infection among patients attending in Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam during the period 2013-2016.</p><p><strong>Methods:</strong> A retrospective study was done from the year 2013 to 2016. A total of 340 serum samples received in the department of microbiology FAAMCH, were tested for the confirmation of suspected cases of dengue. Dengue NS1 antigen and Dengue IgM antibody ELISA tests were performed for the confirmation of dengue cases. We estimated the incidence by applying age, sex and season adjusted dengue positivity.</p><p><strong>Results:</strong> Out of 340 samples tested, 68 were positive either by NS1 antigen or for IgM antibody ELISA tests. These comprised all age groups of both sexes with higher incidence of cases in young males aged 26– 60 years.</p><p><strong>Conclusion:</strong> From this study, it is apparent that dengue surveillance and control should be enhanced by wider use of laboratory testing to confirm dengue as a cause of fever of unknown origin, especially during the local dengue transmission season.</p>


2012 ◽  
Vol 19 (05) ◽  
pp. 661-667
Author(s):  
AMIR RASHID ◽  
HUMAYUN IQBAL KHAN ◽  
NADEEM- UR-RASOOL

Objective: To study the clinical spectrum of Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) in childrenadmitted in a tertiary care center during 2011 dengue epidemic in Lahore. Setting: This study was conducted in department of PediatricsLahore General Hospital (LGH) / Postgraduate Medical Institute (PGMI) Lahore, Pakistan. Design: Retrospective descriptive study. Period: 1stAugust to 31st October 2011. Method: All the children (<18 years) with clinical features of Dengue Hemorrhagic Fever and Dengue shockSyndrome (DHF/DSS) admitted to the Pediatric ward Lahore General Hospital, Lahore during the period of 1st August to 31st October 2011were enrolled in the study. The clinical manifestation were recorded on a standard questionnaire form. Clinically DHF/DSS cases wereconfirmed in the laboratory by different investigations. All the patient were diagnosed, managed and discharged according to WHO protocol.Results: A total of 254 patients were admitted in the ward labeled as dengue fever (DF) clinically. Out of these 142(55.9 %) were confirmed byserology. Of 254 DF cases 37(14.57%) were labeled as DHF and 02(0.79%) as DSS on their clinical manifestations and fulfilling the WHOcriteria. 55% were male and 45%females. Common symptoms were fever seen in 100%, headache 71.79% and vomiting seen in 58.97% of thecases. The most common bleeding manifestations were epistaxis seen in 69.23% of the cases. Positive IgM was noted in 53.9% and IgG in36.6% cases. A decrease in platelet count and increase in Heamatocrit ( Hct) during stay in ward was noted. Out of 39 patients only one patientexpired (2.56%).


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