scholarly journals Spontaneous splenic rupture in dengue fever with non-fatal outcome in an adult

2012 ◽  
Vol 6 (04) ◽  
pp. 369-372 ◽  
Author(s):  
Emmanuel Bhaskar ◽  
Swathy Moorthy
Keyword(s):  
Abdominal Pain ◽  
Dengue Fever ◽  
Splenic Rupture ◽  
Fatal Outcome ◽  
Severe Dengue ◽  
Structural Protein ◽  
Viremic Phase ◽  
Laboratory Investigations ◽  
Splenic Hematoma

A 26-year-old male presented with fever for five days and abdominal pain for 24 hours. System examination identified a soft abdomen with diffuse tenderness. CT-abdomen findings were consistent with splenic rupture with intra and peri-splenic hematoma. Laboratory investigations showed a platelet count of 40,000 per mm3. In due course he developed hypotension and underwent splenectomy. Non-structural protein 1 (NS1) dengue antigen was positive in the admission sample and IgM dengue antibodies were detected in the follow-up sample. Histopathology of the spleen showed normal architecture with no evidence of hyperplasia, cellular infiltrates or haematological malignancy. Splenic rupture is a rare, but potentially fatal complication of dengue fever and severe dengue which should be suspected when a patient presents with abdominal pain and hypotension. Our case highlights the occurrence of splenic rupture in the viremic phase of dengue illness before the development of IgM antibodies. 

scholarly journals Spontaneous Splenic Rupture in Severe Dengue

2013 ◽  
Vol 1 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Ahmad Mursel Anam ◽  
Mohammad Mufizul Islam Polash ◽  
Md Motiul Islam ◽  
Muhammad Mahbubur Rahman Bhuiyan ◽  
ARM Nooruzzaman ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splenic Rupture ◽  
Febrile Illness ◽  
Acalculous Cholecystitis ◽  
Severe Dengue ◽  
Spontaneous Splenic Rupture ◽  
History Of ◽  
Plasma Leakage ◽  
Laboratory Investigations ◽  
High Index Of Suspicion

Dengue is a mosquito-borne systemic viral infection with variety of clinical presentation, ranging from mild febrile illness to severe and fatal disease. A patient presented with history of fever and abdominal pain, and later developed shock. From clinical and epidemiological features, he was diagnosed as a patient of severe dengue, later confirmed by laboratory investigations. In dengue, shock can result from plasma leakage, and abdominal pain may be a feature of acalculous cholecystitis or pancreatitis, recognised presentations of dengue and usually managed conservatively. But high index of suspicion persuaded abdominal imaging, revealing a potentially fatal complication of dengue- spontaneous splenic rupture. Aggressive resuscitation and early surgery saved the patient. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14373 Bangladesh Crit Care J March 2013; 1: 59-62

scholarly journals Causes and Management of Acute Abdominal Pain in Children: A Review Article

2021 ◽  
pp. 14-22
Author(s):  
May Abdullah S. Alanazi ◽  
Abdulaziz Muslih Muhaylan Alsharari ◽  
Ibrahim Awadh R. Alanazi ◽  
Abdulaziz Mashan R. Alanazi
Keyword(s):  
Abdominal Pain ◽  
Emergency Room ◽  
Acute Abdominal Pain ◽  
Symptomatic Treatment ◽  
Review Article ◽  
Pain Site ◽  
Life Threatening ◽  
Laboratory Investigations ◽  
Surgical Conditions

Acute abdominal pain is one of the commonest prevalent grievances in children, and it frequently requires emergency room diagnosis and management. Abdominal pain in children differs with age, concomitant symptoms, and pain site. While most cases of acute abdominal embarrassment are self-limiting and benevolent, there are certain diseases that can be life-threatening and necessitate instant care, such as appendicitis, intussusception, or intestinal obstruction. To decide the cause of acute abdominal pain and recognize children with surgical conditions, scrupulous history taking and numerous physical checkups are mandatory.The most important and realistic first goal in the evaluation of acute AP is to distinguish between surgical and nonsurgical situations, which are further divided into urgent and non-urgent categories. A thorough history and physical examination, laboratory investigations to evaluate comorbidity, and imaging scans are usually used for these purposes. Management decisions should necessitate teamwork between the emergency room physician, a surgeon, and a radiologist. Consecutivereassessment and symptomatic treatment with hardworking follow-up are necessary for management as soon aspossible in urgent disorder.

Study on Clinical Spectrum, Laboratory Profile and Outcome of Dengue Fever in Adults

Mediscope ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 33-39
Author(s):  
Muhammad Ashraful Kabir ◽  
Syed Didarul Haque ◽  
Baishakhi Islam ◽  
Hasan Imam
Keyword(s):  
Abdominal Pain ◽  
Pleural Effusion ◽  
Dengue Fever ◽  
Laboratory Finding ◽  
Dengue Infection ◽  
Febrile Illness ◽  
Clinical Spectrum ◽  
Structural Protein ◽  
Careful Clinical Examination ◽  
Laboratory Profile

Background: Dengue infection is a major health burden, which can result in mild self-limited febrile illness to highly fatal haemorrhagic disease. Infection is caused by Dengue virus, which is transmitted by the Aedes aegypti mosquito. Objective: The aim of the study was to see the clinical spectrum, laboratory profile and outcome of dengue fever in adult. Methods: This prospective observational study was carried out on 75 patients in the department of medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka from 11/07/2019 to 20/10/2019. All patients above 18 years with confirmed dengue, who were either hospitalized or managed as outdoor patients with NS1 (non-structural protein) antigen and/ or IgM dengue antibody positive were included in the study. The patients with concomitant malaria, typhoid and leptospirosis were excluded from the study. Detailed history and careful clinical examination were performed on each patient. Results: In this study, all patients (100%) had fever. Among them, 70 (93.3%) was suffering from headache, 66 (88.0%) myalgia, 32 (42.7%) abdominal pain, 30 (40.0%) conjuctival suffusion, 29 (38.7%) nausea/vomiting, 27 (36.0%) skin rashes, 14 (18.7%) pleural effusion, 13 (17.3%) ascites, 13 (17.3%) retro-orbital pain, 11 (14.7%) itching, 8 (10.7%) hepatomegaly, 7 (9.3%) splenomegaly. Death occurred in 3 (4.0%) patients. Rate of cure was 58 (77.3%) and ICU admission was required in 14 (18.7%), they were ultimately cured. Conclusion: Fever associated with headache and myalgia were the most common symptoms. Other common clinical features were abdominal pain, conjunctival suffusion, nausea/vomiting, skin rashes and pleural effusion. Regarding laboratory finding, platelet count has little role in management of dengue patients. Mediscope Vol. 8, No. 1: January 2021, Page 33-39

scholarly journals Dengue Outbreak in Children During 2019: Experience at A Tertiary Care teaching Hospital

2021 ◽  
Vol 20 (1) ◽  
pp. 46-50
Author(s):  
Mitra Datta ◽  
Asma Ferdousi ◽  
Salina Haque ◽  
Rifat Jahan ◽  
Aparup Das ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pleural Effusion ◽  
Dengue Fever ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Warning Signs ◽  
Severe Dengue ◽  
College Hospital ◽  
Dengue Outbreak

 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

Dengue and post-infection fatigue: findings from a prospective cohort—the Colombo Dengue Study

2020 ◽  
Author(s):  
Ponsuge C Sigera ◽  
Senaka Rajapakse ◽  
Praveen Weeratunga ◽  
Nipun L De Silva ◽  
Laksiri Gomes ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Post Infection ◽  
Prospective Cohort ◽  
Acute Infection ◽  
Severe Dengue ◽  
Fatigue Score ◽  
Dichotomous Outcome ◽  
Patients At Risk ◽  
Clinical Associations

Abstract Background Previous studies on post-infection fatigue in dengue are few but suggest that up to 25% of dengue patients may suffer from fatigue. This study aimed to evaluate the prevalence and associations of post-infection fatigue in dengue patients compared with non-dengue fever patients. Methods Post-infection fatigue and its demographic and clinical associations were assessed in adult dengue and non-dengue fever patients 2 months after the acute infection in a prospective cohort study in Sri Lanka. Fatigue at 2 months (primary endpoint) was assessed with the fatigue questionnaire as a dichotomous outcome based on a pre-recommended cut-off (score ≥4) and as the total score from the questionnaire (higher score indicates more fatigue). Results Of 260 patients, 158 had dengue and, of these, 51 (32%) had fatigue at 2 months. Risk was higher in dengue patients (vs non-dengue; relative risk [RR] 4.93 [95% confidence interval {CI} 2.3 to 10.4]) and more so in female dengue patients (vs male dengue patients; RR 2.45 [95% CI 1.24 to 4.86]). Severe dengue patients had a higher mean fatigue score (p=0.024). Conclusions Post-infection fatigue is an underappreciated burden of this widely prevalent infection. Our findings are useful to triage patients at risk of fatigue for follow-up.

scholarly journals A study on correlation of gall bladder wall thickness with severity of Dengue fever

2019 ◽  
Vol 6 (6) ◽  
pp. 2476
Author(s):  
Vijayalakshmi A. ◽  
Sreelekha P. ◽  
Kalashankar D.
Keyword(s):  
Gall Bladder ◽  
Dengue Fever ◽  
Wall Thickness ◽  
Bladder Wall ◽  
Tertiary Care ◽  
Fatal Outcome ◽  
Warning Signs ◽  
Severe Dengue ◽  
Bladder Wall Thickness ◽  
Gall Bladder Wall

Background: Dengue is an acute viral infection with potentially fatal complications. This study was done to describe the correlation of Gall bladder wall thickness with severity of Dengue fever and to predict the fatal outcome of Dengue fever at the earliest to prevent serious consequences by timely interventions.Methods: This was a hospital based prospective observational study conducted at Niloufer Hospital, a tertiary care pediatric hospital attached to Osmania Medical College, Hyderabad, Telangana, India from October 2017 to November 2018. All children between 1 year to 12 years of age that had clinical features of dengue and who were serologically confirmed were included in this study.Results: Age group most commonly affected was 5-8 years with maximum number of dengue cases without warning signs (55.7%). Majority of severe dengue cases (64.3%) had gall bladder wall thickness >5mm. The correlation between severity of dengue and gall bladder wall thickness was found to be highly significant indicating the higher the severity of dengue more the gall bladder thickness.Conclusions: This study concludes gallbladder wall thickness (GBWT) measured by ultrasonography can be used in children for early prediction of the severity of DHF in children and authors can include gall bladder wall thickness as an admission criteria during epidemics.

scholarly journals A clinical study of early manifestations of dengue fever and outcome in children

2020 ◽  
pp. 15-19
Author(s):  
Udaya Kumar Neelagiri
Keyword(s):  
Platelet Count ◽  
Abdominal Pain ◽  
Dengue Fever ◽  
Mean Value ◽  
Warning Signs ◽  
Clinical Severity ◽  
Severe Dengue ◽  
Who Criteria ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

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

scholarly journals Role of Pro-inflammatory IL-8 and Anti-inflammatory IL-10 Cytokines in Dengue Severity

2021 ◽  
Vol 53 (02) ◽  
pp. 69-75
Author(s):  
Mukesh Sharma ◽  
Keyword(s):  
Dengue Fever ◽  
Severe Disease ◽  
Dengue Infection ◽  
Fatal Outcome ◽  
Inflammatory Cells ◽  
Severe Dengue ◽  
Healthy Controls ◽  
Cytokine Levels ◽  
Ns1 Antigen ◽  
A Prospective Study

Introduction: During dengue infection, cytokine levels may increase as various cytokines are released from infected inflammatory cells. This study was conducted to measure the levels of cytokines IL-8 and IL-10 in dengue patients and correlate them with dengue severity. Material & Methods: A prospective study was conducted on febrile patients suspected of dengue fever, seeking medical care in our institute. 107 cases confirmed to have dengue fever (by NS1/ IgM ELISA) and 100 healthy individuals with age and sex matched, were included in the study. The clinical features of all patients were recorded, and cytokine levels of IL-8 and IL-10 were estimated by ELISA in the dengue patients and healthy controls. Results: Out of 400 febrile patients suspected of having dengue fever, 107 (26.75%) cases were confirmed cases, of which 56 (52.3%), 20 (18.7%), and 31 (29%) were positive for only NS1 antigen, only IgM antibody, and both NS1 and IgM, respectively. Depending on the severity of the disease, 9 (8.5%) cases were classified as severe dengue cases while 98 (91.5%) as non-severe dengue fever. Mean levels (pg/ml) for IL-8 were 281.6 ± 76.6, 150.41 ± 55.9 and 75.4 ± 49.2 in severe dengue, dengue fever, and healthy controls respectively while for IL-10, the values were 219.4 ± 150.5, 38.9 ± 67.2, and 6.6 ± 0.65 among severe dengue cases, dengue cases, and healthy controls, respectively. Conclusion: Mean level of cytokines IL-8 and IL-10 were significantly raised in severe dengue patients as compared to non-severe dengue patients and healthy controls, suggesting their role in causing severe disease and as a potential predictor for disease severity and fatal outcome.

scholarly journals Clinical profile and laboratory characteristics of dengue fever in children: analysis of 2019 outbreak from Bengaluru, Karnataka, India

2020 ◽  
Vol 7 (8) ◽  
pp. 1670
Author(s):  
Poornima Shankar ◽  
Shajna Mahamud
Keyword(s):  
Platelet Count ◽  
Abdominal Pain ◽  
Dengue Fever ◽  
Case Fatality ◽  
Warning Signs ◽  
Severe Dengue ◽  
P Value ◽  
High Morbidity ◽  
High Grade Fever ◽  
Female Ratio

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.

scholarly journals Increasing number of secondary dengue cases: a concern

2019 ◽  
Vol 7 (5) ◽  
pp. 1558
Author(s):  
Kumar S. Abhishek ◽  
Oves Siddiqui ◽  
Anita Chakravarti
Keyword(s):  
Dengue Fever ◽  
Fatal Outcome ◽  
Severe Dengue ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Igg Antibody ◽  
Past Infection ◽  
Igm Antibody ◽  
Igg Avidity ◽  
Increasing Trend

ackground: Dengue fever is caused by mosquito borne arbovirus of family Flaviviridae, Aedes agypti as the principle vector. In the recent past Delhi has witnessed several outbreaks affecting thousands of individuals and many of them get re-infected during subsequent years forming a bulk of secondary dengue cases putting them at risk of developing severe dengue.Methods: A total of 150 serum samples from suspected dengue cases were tested for dengue fever by NS-1 antigen and IgM antibody enzyme-linked immunosorbent assay (ELISA) followed by categorization into primary and secondary dengue using IgG avidity ELISA.Results: Out of total 150 clinically suspected dengue cases, 56 were positive either by Dengue NS-1 antigen or dengue IgM antibody or both. On the basis of dengue IgG avidity ELISA among 56 diagnosed dengue cases, 30 (53.57%) were found to be of secondary dengue.Conclusions: There is increasing trend of dengue cases in Delhi since past one decade. Being hyper-endemic area for dengue, more than 25% population have been reported to have past infection of dengue. Due to increased prevalence and simultaneous circulation of more than one serotypes, number of secondary dengue cases is also increasing. Since majority of severe dengue cases are associated with secondary dengue, early diagnosis and treatment can significantly reduce the fatal outcome. Thus, avidity testing for IgG antibody becomes an important tool.

Sign in / Sign up

Export Citation Format

Share Document