Background:Dengue is the most rapidly spreading mosquito-borne viral disease in the world with a 30-fold increase in incidence in the last 50 years. Approximately, 50 million dengue infections occur annually.Aim:To study the various clinical and laboratory manifestations of dengue in the elderly and observe for any variations in IgM titer elevation with progression of age.Design:Retrospective observational study.Subjects and Methods:Medical charts of all patients admitted to the Division of Geriatrics of the institute during study period were reviewed for collection of demographic, clinical, and laboratory information. The diagnosis of dengue was made based on positive dengue IgM ELISA. An elderly patient referred to one whose age was ≥60 years.Results:Fever and myalgia were noted to be the most common clinical manifestation with only four patients presenting with overt bleeding manifestations. Only one patient presented in delirium and there was no case fatality. Thrombocytopenia was the single most common hematological abnormality noted. Hyponatremia was found to be prevalent in a majority of the patients and were symptomatic in more than half of them. There have been very few studies done worldwide on the varied clinical manifestations of dengue in the elderly.
Gastric antral vascular ectasia (GAVE), also referred to as “watermelon stomach,” is an uncommon, under-reported, yet significant cause of acute or chronic gastrointestinal blood loss in the elderly. It accounts for about 4% of the nonvariceal upper GI bleeds, and diagnosis is established by the demonstration of characteristic watermelon stripes on upper GI endoscopy. The exact cause is unknown but is often associated with many systemic conditions and characterized by chronic anemia. With this case, we wish to emphasize the need to do upper GI endoscopy in all elderly patients undergoing anemia evaluation and to consider this possibility even in the very elderly individuals.
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