Study of Cardiac Manifestation in Patients with Seropositive Dengue Fever and to Find Correlation with Subclinical Cardiac Involvement

2021 ◽  
Vol 8 (12) ◽  
pp. 28-33
Author(s):  
Rishad Ahmed
Keyword(s):  
Dengue Fever ◽  
Cardiac Involvement ◽  
Randomized Study ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Denv Infection ◽  
Left Ventricular ◽  
High Grade Fever ◽  
Plasma Leakage ◽  
Cardiac Manifestation

Objective: The main objective of the present study was to observe the electrocardiogram (ECG) changes in dengue fever and to find correlation with subclinical cardiac involvement. Methods: This was an observational, prospective, non-randomized study. High grade fever for one to five days diagnosed as dengue infection later confirmed by dengue tests (NS1, IgG and IgM ELISA) were included in this study. Prior to the commencement of the study informed consent was taken from all the participants. With 12 lead ECG taken during the febrile phase of dengue fever randomly selected serologically confirmed cases of dengue fever were evaluated at an interval of 24 hrs. for a total of five days. On the day of admission when the patient was afebrile, echocardiography was done. Plasma leakage was diagnosed by presence of any one of four: subcutaneous oedema (pedal oedema, facial puffiness) or pleural effusion or pericardial effusion or ascites. Result: A total 80 patients who were admitted to hospital during study periods due to symptoms of dengue fever and IgM dengue positive status were included in this study. Among this total population of 80 patients (N=80) 48 were male and 32 were female. Out of these, majority were diagnosed as DF 52 (65%), 23 (29%) were diagnosed as DHF and rest only 5 (6%) were diagnosed as DSS. Total 54 patients were found to have normal ECG among which 35 were having dengue fever, 16 were having DHF and 3 were having DSS. Total 2 patients were diagnosed to have left ventricular hypertrophy among which one had dengue fever and rest two had DHF. ST depression was observed in total 7 patients in which 5 were had dengue fever and 2 were had DHF. Relative bradycardia was found in 14, tall t waves in 2 and ventricular ectopics in 1 patient (table 2). Abnormal ECG findings were compared using Chi-square test and were found to be statistically significant (P < 0.05) in dengue fever and DHF. There was statistically significant correlation between ECG abnormalities and abdominal pain and mucosal bleed. The presence of plasma leakage were observed among 77 (96.3%) patients. Proportion of echocardiography abnormalities were higher among patients with plasma leak 6 (30%) as compared to without plasma leak 9 (15%), this difference was not found to be statistically significant Conclusion: In all type of Dengue infections incidence of cardiac involvement was quite high. Due to the overlapping clinical manifestations such as capillary leak associated with DENV infection, tachycardia, pulmonary edema, and hypotension as well as due to the low index of clinical suspicion cardiac involvement in dengue fever is often underdiagnosed. Keywords: Cardiac manifestation, dengue infection, echocardiography, electrocardiography.

scholarly journals Oculogyric Crisis – Atypical Presentation in Patient with Dengue Fever

2021 ◽  
pp. 19-23
Author(s):  
Saurabh Rajkumar Jain ◽  
Jitendra D. Lakhani ◽  
Pramod R. Jha
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Neurological Complications ◽  
Oculogyric Crisis ◽  
Co Morbidity ◽  
Wide Range ◽  
Chief Complaints ◽  
Plasma Leakage ◽  
Multi Organ Dysfunction Syndrome ◽  
Rule Out

Here we are presenting a case of dengue fever presented with an atypical symptom of “oculogyric crisis” with features of multi organ dysfunction syndrome. Increased vascular permeability, plasma leakage, haemorrhagic manifestations, and thrombocytopenia are charecteristics of dengue fever.  A 19 year old male patient, with no co-morbidity came to Dhiraj hospital with chief complaints of  fever which was high grade & intermittent, it is associated with chills & rigours for 5 days. Also complain of abdominal pain over epigastric region, dull aching non radiating associated with decreased appetite since 5 days. Dengue infection has a wide range of clinical features. Neurological complications can occur in any spectrum of dengue infection.  The diagnosis of oculogyric crisis is majorly clinical and it requires a focused detailed history and detailed physical examination to find out possible triggers for the crisis and to rule out other reasons for abnormal eye movements.

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

2018 ◽  
Vol 5 (6) ◽  
pp. 2265 ◽  
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.

scholarly journals Epidemiological and Clinical Features of Dengue Infection in Adults in the 2017 Outbreak in Vietnam

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bui Vu Huy ◽  
Le Nguyen Minh Hoa ◽  
Dang Thi Thuy ◽  
Nguyen Van Kinh ◽  
Ta Thi Dieu Ngan ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Dengue Fever ◽  
Clinical Features ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Severe Bleeding ◽  
Cross Sectional ◽  
Number Of Patients

Purpose. The clinical features and laboratory results of dengue-infected adult patients admitted to the hospital during the 2017 outbreak were analyzed in this study. Method. This is a cross-sectional study. 2922 patients aged 18 years or more with dengue fever in National Hospital for Tropical Diseases (NHTD) in the North and Hospital for Tropical Disease (HTD) in the South of Vietnam were recruited in this study. Result. Patients were admitted in the hospital around the year and concentrated from August to December, in 53/63 (84.0%) provinces in Vietnam, and patients in all ages were affected. The number of patients with dengue fever was 1675 (57.3%), dengue with warning signs 914 (31.3%), and severe dengue 333 (11.4%), respectively. Among patients with severe dengue, severe plasma leakage and dengue shock account for 238 (8.1%), severe organ impairment 73 (2.5%), and severe bleeding 22 (0.75%). The rate of mortality was 0.8%, and the outcome of dengue patients is worse in the elderly and people with underlying diseases. Conclusion. The 2017 dengue outbreak occurred in a larger scale than in the previous years in terms of time, location, and number of patients. More elderly patients were infected by dengue in this outbreak, and this may contribute to the mortality rate. Clinical manifestations of dengue patients in Southern Vietnam are more typical than the northern, but the rate of severe dengue is not different. The mortality risk and underlying conditions associated with dengue-infected elderly patients are worthy of further investigations in the future.

scholarly journals Dengue fever complicated with acute liver failure: A case report of expanded dengue syndrome and literature review

2020 ◽  
Vol 8 ◽  
pp. 2050313X2091342 ◽  
Author(s):  
Navaneethakrishnan Suganthan ◽  
Gajawathana Sakthilingham ◽  
Thirunavukarasu Kumanan
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Dengue Fever ◽  
Dengue Infection ◽  
Dengue Shock Syndrome ◽  
Acute Hepatic Failure ◽  
Fresh Frozen Plasma ◽  
Uneventful Recovery ◽  
Fresh Frozen ◽  
Plasma Leakage

Dengue is the most common arboviral disease, the presentation of which ranges from asymptomatic illness to dengue shock syndrome. Liver is the most common organ affected in dengue, and liver involvement is asymptomatic in majority. Dengue fever is a rare, but a leading cause for acute liver failure in endemic regions. Here, we report a case of a 34-year-old male ethanol user (16 units per week), presented with typical features of dengue infection, which was confirmed serologically, complicated with acute liver failure without clinical, radiological or laboratory evidence of plasma leakage. He was managed with intravenous fresh frozen plasma and N-acetyl cysteine along with other recommended supportive therapies for acute hepatic failure. He made an uneventful recovery.

Shock Prognostic Factors in Hospitalized Dengue Hemorrhagic Fever Children

2018 ◽  
Vol 24 (8) ◽  
pp. 6221-6224
Author(s):  
Hindra Irawan Satari ◽  
Rossy Agus Mardani ◽  
Hartono Gunardi
Keyword(s):  
Prognostic Factors ◽  
Dengue Hemorrhagic Fever ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Health Department ◽  
Abdominal Tenderness ◽  
Diverse Area ◽  
Plasma Leakage

Various clinical manifestations, complex pathogenesis and different virus serotypes in diverse area make us difficult to predict course of disease, even the child admitted in early. Prognostic factors are very important to predict cases progressing to become DSS. Dengue shock syndrome (DSS) occurs in 15.53% of Dengue hemorrhagic fever (DHF) patients with 7.81% mortality rate. Aim: To explore the prognostic factors of shock in hospitalized DHF children regarding the new 2011 WHO dengue virus infection classification guideline. This was a retrospective study using medical records of children age below 18 years old with WHO fulfilled grade 1 and 2 DHF diagnosis from January 2013–December 2016 in Child Health Department of Dr. Cipto Mangunkusumo Hospital, Jakarta. Independent variables were sex, age, nutritional status, secondary dengue infection, leucopenia, abdominal tenderness, gastrointestinal bleeding, hepatomegaly and plasma leakage. Shock was dependent variable. Multivariate analysis was done by using logistic regresion analysis. There were 98 DHF subjects, 5 subjects became DSS during hospitalization. DSS subject characteristics were age of >5 years old, female, malnutrition, abdominal tenderness, hemoconcentration ≥20%, secondary dengue infection, leucocyte ≥5.000 mm3 and thrombocyte <50.000 mm3. Multivaryate analysis showed malnutrition and hepatomegaly were prognosis factors of DSS. Malnutrition and hepatomegaly were prognotic factors of dengue shock syndrome. Clinicians should be more aware with these factors when managed hospitalized DHF patients.

scholarly journals Presentation, Management and Outcome of Dengue Fever – A Study of 200 Cases

2013 ◽  
Vol 14 (1) ◽  
pp. 18-22
Author(s):  
Md. Habibur Raman ◽  
Abu Yousuf Md. Shahidul Alam ◽  
AKM Mijanur Rahman ◽  
Md. Sarwar Khan ◽  
Nahid Reaz Shapla ◽  
...  
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Skin Rash ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Blood Platelet ◽  
Viral Disease ◽  
Female Ratio ◽  
General Weakness

Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the world1. The rapidly expanding global footprint of dengue is a public health challenge. The endemicity of dengue is also increasing in Bangladesh. This study highlights our current understanding of dengue, including its clinical manifestations, laboratory tests, management and outcome. Objectives: This study was designed to document the presenting features and outcome of Dengue infection in Border Guard personnel. Materials and Methods: It was a prospective observational study which was carried out among outpatient and indoor cases from February 2011 to November 2012 in Border Guard Hospital, Dhaka which is a 300 bedded hospital. Total 200 cases were enrolled. A detailed history, clinical examinations and relevant investigations were done. Data were collected in a predesigned structured questionnaire and analyzed with the help of SPSS-16.0 and Chisquare (X2) Test. Results: A total of 200 adult seropositive Dengue cases of various grade were studied. Among these 152(76%) were male and 48 (24%) were female. Male to female ratio was 3.17:1.The age range of the patients was 18 to 60 years and the mean age 39±12.56 years. Among 200 patients, 112(66%) were Dengue Fever (DF) and 88(44%) were Dengue Haemorrhagic Fever (DHF) including 3(1.5%) cases of DHF Grade lII but none (0%) had Grade-IV DHF. All the patients presented with fever 200(100%), general weakness 200(100%) followed by various skin rash 196(98%), headache 192(96%), myalgia/arthralgia 191(95.5%), retroorbital pain 84(42%). Bleeding manifestation showed in 94(47%) cases of which petechiae was most frequent 86(43%), Haematocrit was normal only in 13(6.5%) patients and 82(41%) had a rise of >20%; Leucopenia was found in 187(93.5%) patients.Only 2(1%) patients had normal platelet count and 03(1.5%) patients had platelet count of less than 10X109 /L. Raised serum alanine aminotransferase (ALT) was observed in 184(92%) of cases. All (200%) the patients recovered completely from the disease; however, one patient subsequently developed Guillein Barre Syndrome. Conclusion: High persistent fever, profound general weakness, myalgia, headache and itchy skin rash were the usual presenting features. Most of the patients recovered well with efficient symptomatic and supportive treatment. Very few cases required blood/platelet transfusion. There was no case fatality in this study group DOI: http://dx.doi.org/10.3329/jom.v14i1.14531 J MEDICINE 2013; 14 : 18-22

scholarly journals COVID-19 and Dengue infection in Bangladesh: a case of coinfection where hemoptysis as first presentation

2021 ◽  
Author(s):  
Mohammad Ashraful Amin ◽  
Md. Taufiqul Islam ◽  
Ishtiakul Islam Khan ◽  
Zahid Hasan Khan ◽  
Firdausi Qadri ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Sore Throat ◽  
Dengue Infection ◽  
High Grade ◽  
Rt Pcr ◽  
High Grade Fever

Bangladesh recently faced large outbreaks of both COVID-19 and Dengue fever. A 28-year-old woman suffered from symptoms including hemoptysis as first presentation followed by high-grade fever, sore throat, and fatigue. SARS-CoV-2 was confirmed by RT-PCR and also diagnosed dengue later on.COVID-19 and dengue fever could be a harmful combination.

scholarly journals Lyme Borreliosis as Cause of Myocarditis: A Case Report and a Review of the Literature

2021 ◽  
Vol 07 (12) ◽  
Author(s):  
Yousra Serroukh ◽  
Keyword(s):  
Case Report ◽  
Lyme Disease ◽  
Lyme Borreliosis ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Review Of The Literature ◽  
Conduction Disorders ◽  
Lyme Carditis ◽  
The Subject ◽  
Cardiac Manifestation

lyme borreliosis (LB) is the most common tick-born disease in the Northern Hemisphere. During early disseminated Lyme disease, cardiac manifestation can occur. including acute conduction disorders, atrioventricular block, acute myopericarditis or left ventricular dysfunction and rarely cardiomegaly or fatal pericarditis. We report a case of a patient with isolated Lyme myocarditis manifested by acute heart failure with atrial fibrillation and review of the literature on the subject. The interested of this case report is to show the need to acquire the reflex to think about a lyme carditis when patients in endemic areas come to attention with cardiovasculair symtoms, even in the absence of others concurerenr clinical manifestations of early lyme disease.

scholarly journals Management of Dengue in Children: An Update

2020 ◽  
Vol 35 (2) ◽  
pp. 162-178
Author(s):  
Mirza Md Ziaul Islam
Keyword(s):  
Fluid Resuscitation ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Therapeutic Index ◽  
Severe Dengue ◽  
Management Problem ◽  
Aggressive Fluid Resuscitation ◽  
Critical Phase ◽  
Plasma Leakage ◽  
Severity Of The Disease

Dengue viruses cause symptomatic infections or asymptomatic seroconversion. Symptomatic dengue infection is a systemic and dynamic disease. It has a wide clinical spectrum that includes both severe and non-severe clinical manifestations. Due to its dynamic nature, the severity of the disease will usually only be apparent around defervescence which often coincides with the onset of the critical phase. For a disease that is complex in its manifestations, management is relatively simple, inexpensive and very effective in saving lives, so long as correct and timely interventions are instituted. The main hemodynamic elements of dengue shock is hypovolemia with decreased vascular capacitance resulting from plasma leakage. Thus, the strategy of aggressive fluid resuscitation of septic shock is not applicable to severe dengue with plasma leakage. Volume replacement in children with dengue shock is a challenging management problem. Aggressive fluid resuscitation may indeed be harmful and should be limited to dengue shock with hypotension. There is a “narrow therapeutic index”; therefore, fluids have to be given timely, at the appropriate volume, rate, of the appropriate type (crystalloids, colloid and/or blood) and for the appropriate duration. Therein lies the challenge to physicians who are not familiar with the important practice of fluid titration through frequent and meticulous assessment. Progression of the disease through the critical phase should be tracked in hours of plasma leakage. Recognizing the cues to discontinue intravenous fluid therapy is just as important as knowing when to start it. Given time and hemodynamic stability, other issues such as thrombocytopenia, coagulopathy and raised liver enzymes will recover spontaneously or with supportive care. DS (Child) H J 2019; 35(2) : 162-178

scholarly journals An unusual association of disseminated staphylococcal infection in dengue fever

2021 ◽  
pp. 391-394
Author(s):  
Sruthi Haridas ◽  
Renoy A Henry ◽  
Abhishek C Menon ◽  
Anup Menon ◽  
L Sasikala ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Dual Infection ◽  
Denv Infection ◽  
Staphylococcal Infection ◽  
Healthy Male ◽  
Unusual Association ◽  
Host Innate Immunity ◽  
Igm Deficiency ◽  
Expanded Dengue Syndrome

Dengue fever is an important mosquito-borne disease with a highly variable clinical spectrum, ranging from self-limiting mild illness to expanded dengue syndrome (EDS). While the immune-pathogenesis of dengue virus (DENV) infection had been studied thoroughly, the exact mechanism remains elusive. The transient suppression of host innate immunity by DENV might be the likely reason for dengue-associated co-infections and/or superinfections. In addition, the dual infection can worsen the clinical outcome of Dengue fever. We are reporting a case of disseminated staphylococcal infection in a 31-year-old healthy male with a recent dengue infection. Blood culture showed methicillin-sensitive Staphylococcus aureus. Selective IgM deficiency has been proved in this patient, which might explain, the occurrence of disseminated staphylococcal septicemia. This case report highlights the importance of early detection of atypical features and the emerging entity called EDS

Sign in / Sign up

Export Citation Format

Share Document