CLINICAL AND HEMATOLOGICAL PROFILE OF PATIENTS WITH DENGUE FEVER AT A TERTIARY CARE HOSPITAL – AN OBSERVATIONAL STUDY

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.

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FACTORS PREDICTING MORBIDITY IN PATIENTS WITH DENGUE FEVER IN A TERTIARY CARE HOSPITAL

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2013.014 ◽

2013 ◽

Vol 5 (1) ◽

pp. e2013014 ◽

Cited By ~ 11

Author(s):

Muhammad Imran Hasan Khan ◽

Eram Anwar ◽

Adnan Agha ◽

Noha Saleh ◽

Ehsan Ullah ◽

...

Keyword(s):

Risk Factors ◽

Dengue Fever ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Denv Infection ◽

Care Hospital ◽

Factors Associated ◽

Logistics Regression

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.

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Clinico-epidemiological profile of paediatric dengue patients in a tertiary care hospital: a retrospective study in Visakhapatnam, Andhra Pradesh, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204739 ◽

2020 ◽

Vol 7 (11) ◽

pp. 4424

Author(s):

Chilakala Padmavathy ◽

B. Devi Madhavi ◽

S. Suneetha ◽

Suresh Babu Chaduvula

Keyword(s):

Abdominal Pain ◽

Dengue Fever ◽

Tertiary Care ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Viral Disease ◽

Care Hospital ◽

Age Group ◽

Hospital Data ◽

Cross Sectional

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.

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Importance of Platelet Count and Hematocrit in Dengue Fever in Children

Bangladesh Journal of Child Health ◽

10.3329/bjch.v44i2.51129 ◽

2021 ◽

Vol 44 (2) ◽

pp. 74-77

Author(s):

Farhana Rahat ◽

Morsheda Khanam ◽

Kazi Iman ◽

UK Ghosh ◽

NK Ghosh

Keyword(s):

Platelet Count ◽

Dengue Fever ◽

Dengue Hemorrhagic Fever ◽

Dengue Infection ◽

Tertiary Care ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Warning Signs ◽

Care Hospital ◽

Pediatric Age Group

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

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THE STUDY OF DETECTION OF DENGUE CASES BY NS1 ANTIGEN AND IGM ANTIBODY IN RIMS, ADILABAD, INDIA.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i11.720 ◽

2019 ◽

Vol 3 (11) ◽

Author(s):

Dr. Tanajee Zade ◽

Dr. K. Srinivas ◽

Dr. Akshay Berad

Keyword(s):

Early Diagnosis ◽

Dengue Fever ◽

Dengue Infection ◽

Tertiary Care ◽

High Morbidity ◽

Care Hospital ◽

Serum Samples ◽

Igg Antibody ◽

Igm Antibody ◽

Ns1 Antigen

Dengue fever is an acute febrile arboviral disease affecting tropical & subtropical regions of the world. Dengue infection produces a spectrum of clinical illness, ranging from an asymptomatic to its most severe form like dengue haemorrhagic fever and dengue shock syndrome. In view of high morbidity and mortality, it is imperative to have a rapid and sensitive laboratory assay for early detection of the dengue infection. The newer parameter NS1 antigen has gained a lot of interest for early diagnosis of the disease. Detection of non-structural antigen (NS1 Ag), IgM and IgG antibody may help in the early diagnosis. The present study was conducted in a RIMS Adilabad, tertiary care hospital & medical college in the Department of General Medicine. A total of 100 serum samples were processed from suspected cases of dengue fever by using dengue test for detection of NS1 antigen and IgG antibodies. Platelet counts of all these cases were noted. . Of these 100 subjects 85 were serologically proved to have dengue illness, 57 patients were NS1 antigen positive, 28 patients were IgM antibody positive patients. As the NS1 antigen is detectable in blood from day one after onset of fever, its assay is an effective tool for early diagnosis of dengue infection so as to avoid complications. Key words: Dengue, NS1 Antigen, IgM antibody, Platelet

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

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20194204 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1554

Author(s):

Srikant Kumar Dhar ◽

Swati Samant ◽

Pramod Kumar Tudu ◽

Debasmita Tripathy ◽

Vujwal Roy K. ◽

...

Keyword(s):

Tertiary Care ◽

Clinical Manifestations ◽

Febrile Illness ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Clinical Spectrum ◽

Care Hospital ◽

Ns1 Antigen ◽

Bleeding Manifestation ◽

Vector Borne

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.

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

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20210969 ◽

2021 ◽

Vol 8 (4) ◽

pp. 631

Author(s):

S. V. S. Sreedhar ◽

Ramishetty M. Umamahesh

Keyword(s):

Dengue Fever ◽

Tertiary Care ◽

Febrile Illness ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Clinical Profile ◽

High Morbidity ◽

Care Hospital ◽

Medical Sciences ◽

Low Platelet Count

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.

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Study of incidence, manifestations and complications of dengue fever

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam201180072 ◽

2018 ◽

Vol 5 (1) ◽

pp. 137

Author(s):

Jahnavi K. ◽

Srinivasulu T.

Keyword(s):

Platelet Count ◽

Dengue Fever ◽

Dengue Infection ◽

Tertiary Care ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Simple Random Sampling ◽

Study Data ◽

World Health ◽

Care Hospital

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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A study on the outbreak of dengue fever in a tertiary care children’s hospital in southern Tamil Nadu, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192011 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1194

Author(s):

Belgin Premkumar ◽

Baburaj S. ◽

Margaret Hepzibah N. ◽

Misha K. P. ◽

Binu Abraham

Keyword(s):

Dengue Fever ◽

Tamil Nadu ◽

Tertiary Care ◽

Case Fatality ◽

Dengue Shock Syndrome ◽

Viral Disease ◽

Severe Dengue ◽

Care Hospital ◽

Clinical Criteria ◽

Public Health Challenge

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.

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Dengue Fever : Study of 100 Cases in a Tertiary Care Hospital in Dhaka City

Journal of Medical Science & Research ◽

10.47648/jmsr.2015.v2401.01 ◽

2015 ◽

Vol 24 (Number 1) ◽

pp. 3-7

Author(s):

A H M Karnal ◽

K H Mollah ◽

A Begum ◽

K Khoda ◽

S Tanzeem ◽

...

Keyword(s):

Dengue Fever ◽

Tertiary Care ◽

Hemorrhagic Fever ◽

Viral Disease ◽

Care Hospital ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Male To Female ◽

Body Ache

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.

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Clinical profile of dengue fever in children: analysis of 2017 outbreak from Central Kerala, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20184293 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2265 ◽

Cited By ~ 1

Author(s):

Senthil Kumar K. ◽

Rajendran N. K. ◽

Ajith Brabhukumar C.

Keyword(s):

Dengue Fever ◽

Dengue Infection ◽

Tertiary Care ◽

Hemorrhagic Fever ◽

Warning Signs ◽

Clinical Profile ◽

Severe Dengue ◽

High Morbidity ◽

Care Hospital ◽

High Grade Fever

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.

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