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 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 Clinical and laboratory profile of dengue fever: a retrospective study

2019 ◽  
Vol 6 (4) ◽  
pp. 1254
Author(s):  
Sachin N. Solanke ◽  
Abhay S. Pohekar ◽  
Jayshree A. Pohekar
Keyword(s):  
Platelet Count ◽  
Abdominal Pain ◽  
Dengue Fever ◽  
Dengue Infection ◽  
Recent Decade ◽  
High Morbidity ◽  
Normal Platelet ◽  
Bone Marrow Diseases ◽  
Number Of Patients ◽  
Low Platelet Count

Background: The global incidence of dengue has grown dramatically in recent decade. Half of world’s population is now at risk. India represents significantly a larger burden, accounting for nearly 34% of the global burden of dengue infection. Dengue infection needs to be addressed as a single disease with different clinical presentations ranging from asymptomatic conditions to severe clinical courses that may lead to high morbidity and mortality.Method: This was retrospective observational study carried out during period of July 2017 to April 2018, to study clinical profile and laboratory parameters in dengue fever patients. Confirmed dengue cases having NS1 positive or IgM positive or having both NS1 and IgM positive or dengue ELISA reactive, having minimum one CBC reports done and not having other confounding factor such as co-infection, bone marrow diseases etc. that may altered clinical and laboratory results are included in study. Statistical analysis was done by SPSS software version 18.0.Results: Out of 48 confirmed dengue cases maximum patients 58.33% was from young age group (21 to 40 years) with M:F ratio was 2.43:1. Fever was found in 100% patients, in order of frequency followed by headache, bodyache, abdominal pain, weakness, retro-orbital pain, anorexia, dry cough, back pain, nausea, diarrhoea, vomiting, rash, joint pain, itching and malena.NS1was positive in 41.67% cases, dengue ELISA in 31.25%, IgM was positive in 20.83% cases, and both NS1 and IgM positive were in 4.17% cases. TLC count was low 35.42%, high in 12.50% of cases and remaining had normal TLC count. Platelet count was ranged between normal platelet counts to thrombocytopenia. One case had platelet count less than 20000. Out of 48 patients, 2 (4.17%) had malena.Conclusion: In this study, fever was found in all patients, and headache, body ache and weakness were common symptoms, but significant number of patients also had gastroentstinal and respiratory symptoms like abdominal pain, nausea, diarrhea, vomiting and dry cough. TLC count ranging from normal TLC, leukopenia to leucocytosis. Large number of patients had low platelet count that shows dengue fever had varied clinical presentation. 

ROLE OF PLATELET PARAMETERS IN DENGUE FEVER IN CHILDREN

2021 ◽  
pp. 42-43
Author(s):  
Mithilesh Kumar ◽  
R. K. Sinha ◽  
Debarshi Jana
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Recovery Phase ◽  
Warning Signs ◽  
Severe Dengue ◽  
Distribution Width ◽  
Female Ratio ◽  
Group A ◽  
Group B

Aim: To evaluate the role of platelet parameters in dengue fever and also to determine relationship of platelet parameters with platelet count and the severity of the disease. The platelet para Materials and methods: meters [platelet count, plateletcrit, mean platelet volume (MPV), platelet distribution width (PDW)] of 50 dengue infected children were calculated using BC 3000 plus Mindray Automated Hematology Analyzer. Normal range of MPV is 7.5-11.5 . Plateletcrit cut off value in thrombocytopenia is 0.2-0.36%. The PDW reported varies with reference intervals ranging from 8.3 to 56.6%. Subjects were divided into four groups according to their platelet count on day 3 of illness (<20,000 cells/cumm, 20,000 to 50,000 cells/cumm, 50,000 to 100,000 cells/cumm and >100,000 cells/cumm). Platelet indices were studied among these groups and also the indices were evaluated with respect to the severity of disease as group A (dengue without warning signs), group B (dengue with warning signs and group C (severe dengue). Results: Male: female ratio was 28:22. Mean age of presentation was 7.8 + 2.2 years. Thirty-ve patients belonged to Group A, 26 to group B and 2 belonged to group C. PLT (cells/cumm) on Day 3 and Day 7 was 91,828 ±33,532 vs 195,371 + 70,586 in Group A patients (p<0.0001), 69,076 ±45,904 vs 163,230 + 85,053 in Group B patients (p=0.0018) 38,500 + 38,890 vs 86,000 + 28,284 in Group C patients (p=0.29). PCT (%) on Day 3 and Day 7 was 0.09 + 0.04 vs 0.18 + 0.06 in Group A patients (p<0.0001), 0.07 + 0.04 vs 0.15 + 0.07 in Group B patients (p=0.0009) and 0.04 + 0.04 vs 0.08 + 0.28 in Group C patients (p=0.84). MPV () on Day 3 and Day 7 was 10.73 + 1.07 vs 11.34 + 1.09 in Group A patients (p=0.0212), 10.41 + 1.39 vs 10.87 + 0.99 in Group B patients (p=0.3389), 9.35 + 1.62 vs 10.3±1.41 in Group C patients (p=0.59). PDW () on Day 3 and Day 7 was 14.46 ± 1.35 vs 13.22 + 1.10 in Group A patients (p=0.0001), 14.61 + 1.36 vs 13.0 + 0.76 in Group B patients (p=0.0011) and 14.5 + 1.84 vs 13.5 + 0.71 in Group C (p=0.54). Though MPV was lower in patients with platelet count <20,000 cells/cumm (8.57 + 0.5 ) as compared to other groups, it was not statistically signicant (p=0.325). PCT increases with increase in platelet count on Day 3 and Day 7 (p=0.000). Though PDW was lower on Day 3 in patients with platelet count <20,000 cells/cumm as compared to the other 3 groups, it was not statistically signicant (p=0.0740). Conclusion: Lower platelet count and low PCT are seen with severe dengue, increasing platelet count and PCT suggest recovery phase of dengue. MPV had no correlation with severity of dengue or level of thrombocytopenia suggestive that there is no role to predict severity of dengue. PDW does not uctuate with severity of dengue or level of thrombocytopenia

Is there any association between body mass index and severity of dengue infection?

2021 ◽  
Author(s):  
Mohd Syis Zulkipli ◽  
Sanjay Rampal ◽  
Awang Bulgiba ◽  
Devi Peramalah ◽  
Nor'Ashikin Jamil ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Platelet Count ◽  
Dengue Fever ◽  
Body Mass ◽  
Dengue Infection ◽  
Mixed Effects ◽  
Warning Signs ◽  
Severe Dengue ◽  
Full Blood Count ◽  
Response Analysis

Abstract Background Dengue, an acute infectious disease caused by a flavivirus, is a threat to global health. There is sparse evidence exploring obesity and the development of more severe dengue cases in adults. With increasing prevalence of obesity in areas with a high risk of dengue infection, obesity may increase the burden and mortality related to dengue infection. Our study aimed to determine the association between obesity and the development of more severe dengue infection in primary healthcare settings and whether these associations were modified by dengue fever phase. Methods A cohort study was conducted among laboratory-confirmed dengue patients aged &gt;18 y in the central region of Peninsular Malaysia from May 2016 to November 2017. We collected demographic, clinical history, physical examination and laboratory examination information using a standardized form. Dengue severity (DS) was defined as either dengue with warning signs or severe dengue. Participants underwent daily follow-up, during which we recorded their vital signs, warning signs and full blood count results. Incidence of DS was modeled using mixed-effects logistic regression. Changes in platelet count and hematocrit were modeled using mixed-effects linear regression. The final multivariable models were adjusted for age, gender, ethnicity and previous dengue infection. Results A total of 173 patients were enrolled and followed up. The mean body mass index (BMI) was 37.4±13.75 kg/m2. The majority of patients were Malay (65.9%), followed by Chinese (17.3%), Indian (12.7%) and other ethnic groups (4.1%). A total of 90 patients (52.0%) were male while 36 patients (20.8%) had a previous history of dengue infection. BMI was significantly associated with DS (adjusted OR=1.17; 95% CI 1.04 to 1.34) and hematocrit (%) (aβ=0.09; 95% CI 0.01 to 0.16), but not with platelet count (x103/µL) (aβ=−0.01; 95% CI −0.84 to 0.81). In the dose response analysis, we found that as BMI increases, the odds of DS, hematocrit levels and platelet levels increase during the first phase of dengue fever. Conclusion Higher BMI and higher hematocrit levels were associated with higher odds of DS. Among those with high BMI, the development of DS was observed during phase one of dengue fever instead of during phase two. These novel results could be used by clinicians to help them risk-stratify dengue patients for closer monitoring and subsequent prevention of severe dengue complications.

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

scholarly journals A study of various hepatic manifestations in dengue fever and their correlation with severity of dengue fever

2020 ◽  
Vol 7 (3) ◽  
pp. 527
Author(s):  
Shravya Dhanwada ◽  
Samba Siva Reddy R.
Keyword(s):  
Dengue Fever ◽  
Complete Blood Count ◽  
Dengue Infection ◽  
Liver Function Tests ◽  
Warning Signs ◽  
Severe Dengue ◽  
Serum Total Bilirubin ◽  
Hepatic Involvement ◽  
Elevated Liver Enzymes ◽  
A Prospective Study

Background: Hepatic involvement in Dengue is known with protean of manifestations ranging from hepatomegaly, elevated liver enzymes to fulminant hepatic failure. Aim of the study was to study the hepatic manifestations in children with dengue illness.Methods: This is a prospective Study with 60 Patients hospitalized with Dengue infection (Seropositive for Dengue). Dengue Seropositive patients are selected and examined for Hepatomegaly and Jaundice and subjected to complete blood count and Liver function tests were analysed.Results: Of 60 serologically confirmed cases hospitalized with dengue, were classified into (i)(DF), (ii) DHF I (iii) DHF II (iv) DHF III and (v) DHF IV.  In our study, upon 60 seropositive cases were reported at our hospital during the study period of which 18 were DF, 12 were DHF I, 15 were DHFII, 8 were DHF III and 7 were DHF IV respectively. The Hematocrit levels were raised 20% from the baseline in four classes of Dengue and not raised in DF. Most commonly occurred in age group of 5-7 years. Hepatomegaly was the commonest clinical sign seen. Thrombocytopenia was seen in 88% of all cases. Serum total bilirubin was raised in 10% of subjects with severe dengue infection in DHF III and DHF IV. Serum SGOT and SGPT was raised in 63.3% and 56.7% of patients with dengue of all classes including DF respectively. Thrombocytopenia occurred in 75% of patients with dengue fever, 98% with warning signs and 100% in severe dengue.Conclusions: In developing country like India, incidence of dengue outbreaks is increasing. Hepatic involvement of varying degrees have been reported. As hepatic dysfunction in dengue is transient and reversible, early identification of the same would help to reduce life threatening complications. The role of hepato protective drugs in reducing morbidity and mortality should be analysed by further studies. 

scholarly journals Clinical profile and outcome of dengue fever in a paediatric tertiary care centre

2017 ◽  
Vol 4 (3) ◽  
pp. 875
Author(s):  
Md Khaja Moinuddin ◽  
Sahana Devadas Sahana Devadas
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Warning Signs ◽  
Severe Dengue ◽  
Tertiary Care Centre ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Stable Conditions ◽  
Elevated Liver Enzymes

Background: A study of different presentation and outcome of dengue fever in tertiary care centre.Methods: the observational cross sectional study was carried out from June to October 2016 in Bowring and Lady Curzon hospital attached to Bangalore Medical College and Research Institute. Included patients from 1 to 18 years of age who presented with febrile illness. WHO classification and definitions were used to classify disease as dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Clinically, haematological and biochemical findings were recorded till discharge.Results: during study period,142 patients presented with typical features of dengue fever, male being 86 (60%) and female being 56 (40%). Among 142 cases 64 cases were probable dengue, 50 cases were dengue with warning signs and 28 cases were had severe dengue. Fever (100%) was the most common clinical presentation followed by vomiting (70%), body ache (43%), abdominal pain (23%), headache (12%) and rashes (5%). Laboratory findings included thrombocytopenia, leucopenia and elevated liver enzymes. 126 (88%) cases were discharged in clinical stable conditions, (8%) were died during course of treatment and 8 cases left against medical advice.Conclusions: fever with vomiting and thrombocytopenia were most common presentation of dengue fever, appropriate clinical diagnosis and management is relatively simple, inexpensive and very effective in saving lives as long as long correct and timely interventions instituted. 

scholarly journals The coagulation profile of children admitted with dengue fever and correlation with clinical severity

2017 ◽  
Vol 4 (6) ◽  
pp. 2109
Author(s):  
Vijayakumar Balakrishnan ◽  
Simna L. L ◽  
Lalitha Kailas
Keyword(s):  
Dengue Fever ◽  
Neglected Tropical Diseases ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Warning Signs ◽  
Clinical Severity ◽  
Severe Dengue ◽  
Mean Values ◽  
Coagulation Profile ◽  
Significant Difference

Background: Dengue is one of the 17 Neglected Tropical diseases (NTD) addressed in the NTD road map. Objective of present study was to find out the correlation between coagulation profile abnormalities and clinical severity of dengue fever.Methods: All cases of dengue fever in children below 12 years of age admitted to a tertiary care medical college of South India for a period of 18 months (January 2013- June 2014) were included in the study. The liver function tests, prothrombin time, International normalises ratio and activated partial thromboplastin level were estimated and correlated with severity.Results: Of the 306 cases of children admitted with dengue fever, 131 (42.8%) were dengue fever without warning signs, 119 (38.8%) were dengue fever with warning signs and 56 (18.4%) were severe dengue according to WHO guidelines 2012. 20.9% cases had significant PT prolongation, 50.3% had INR >1.1 and 33.3% had aPTT prolongation. Of the 56 cases of severe dengue, 83.9% had PT prolongation, 96.4% had INR >1.1 and 91.1% had significant aPTT prolongation. The mean values of PT, INR and aPTT in severe dengue was 19±3.7sec, 1.5±0.3 and 46±7 sec respectively. These were well above the cut off values and showed statistically significant association with severe dengue (p<0.001) compared to non-severe dengue. Similarly, ALT elevation among the total cases also showed majority (67.3%) in the range of 40-400. Of the 56 cases of severe dengue, 30% had values above 1000 IU/l, 51% had AST levels 40-400, and 16% had 400-1000 and 2.5% below 40. Statistical analysis showed significant difference in AST and ALT elevation among dengue fever without warning signs, dengue fever with warning signs and severe dengue (p<0.001).Conclusions: There is statistically significant association between prolongation of coagulation markers and severity of dengue. 

scholarly journals Clinical profile of dengue fever in children presented at a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 761
Author(s):  
Senthilkumar K. M. ◽  
Hema Harini R.
Keyword(s):  
Platelet Count ◽  
Abdominal Pain ◽  
Dengue Fever ◽  
Dengue Shock Syndrome ◽  
Clinical Profile ◽  
Severe Dengue ◽  
Enzyme Linked Immunosorbent Assay ◽  
Care Hospital ◽  
Body Pain ◽  
Loss Of Appetite

Background: Dengue fever is a benign syndrome caused by an arthropod-borne virus and is characterized by Biphasic fever, myalgia, and arthralgia, rash, leucopenia, and lymphadenopathy. Dengue hemorrhagic fever and dengue shock syndrome are a severe, often fatal febrile disease caused by 1 of 4 dengue virus. It is characterized by increased capillary permeability, abnormalities of hemostasis and protein-losing shock syndrome. The aim of this study was to assess the clinical profile, complications and outcome of dengue infection in children.Methods: All children attending the hospital with symptoms and signs suggestive of dengue fever were tested for NS1 antigen and IgM/ IgG dengue antibody serology (depending on the day of fever) by enzyme-linked immunosorbent assay (ELISA) technique.Results: Of the 174-dengue serology positive children, fever was the most common major symptom (97.7%) followed by vomiting (85.6%), loss of appetite (81.6%), abdominal pain (77%), body pain/leg pain (62.6%). Severe dengue as per WHO criteria was seen in 29 (16.7%) children. Thrombocytopenia (platelet count less 1,00,000) was observed in 82 children (47%), Platelet count less than 20,000 in 8 children (4.5%). Dengue shock syndrome was seen it 26 children (15%). Mortality was nil.Conclusions: In children, if symptoms like fever, vomiting, loss of appetite, abdominal pain and body pain are present, a strong possibility of dengue fever is present especially in an epidemic setting. Early suspicion and effective management can reduce the severity.

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