BACKGROUND Dengue fever is expanding in newer areas globally, with greater morbidity and mortality. We wanted to determine the proportion of bleeding manifestations among the confirmed dengue fever patients and evaluate the clinical outcomes in those with bleeding manifestations. METHODS 230 Dengue confirmed patients admitted in Government Medical College, Ernakulam from January 2018 to December 2018 were enrolled for the study. Data was recorded and entered in Microsoft Excel, and analysed using SPSS. RESULTS In the current study out of 230 subjects, bleeding manifestations were more common in 21 - 30 & 41 - 50 age groups. Out of 230 subjects, 102 had bleeding manifestations (44.3 %) like petechiae (34 %), purpura (24 %), echymosis (19.1 %), gum bleeding (17.8 %), menorrhagia (10.9 %), melena (10.4 %), conjunctival haemorrhage (9.1 %), haematuria (4.8 %), epistaxis (3.5 %), haemoptysis (2.2 %) and hematemesis (0.9 %). 86 subjects (37.4 %) received platelet transfusion on an average of 4 units. Age group, fever, previous history of dengue, IgG positivity, NS1 positivity were significantly (P < 0.0001) associated with bleeding. Most of the bleeding manifestations were significant in patients who had lower platelet counts on the first day of admission when it was less than ten thousand. CONCLUSIONS 44.3 % had bleeding manifestations with significant association between age, fever and IgG positivity. A low platelet count on admission especially less than 10,000 was significantly associated with these bleeding manifestations. These significant observations are important for both the primary care and tertiary care physicians in meticulous management and referral of dengue patients. KEY WORDS Dengue Fever, Bleeding Manifestations, Ns1 Antigen, Platelet Count.
Background: Floods are an important source of infection epidemic worldwide. Analysis of different infections presenting during floods can lead us to have a unified approach during such periods.Methods: This study describes the clinical features of fever patients presented to a tertiary care hospital in Kerala after the 2018 flood. Clinical findings of the confirmed leptospirosis cases were also compared with non-leptospirosis cases.Results: A total of 48 patients with fever and myalgia were studied and majority of them were males (77%). 40 patients had contact with contaminated water. But only 10 of them had taken prophylactic doxycycline. Complications were seen less among those who took prophylactic doxycycline. The mean time from the first symptom to first medical care was 4.4 days. Leptospirosis was seen among 15 patients and 2 patients had dengue fever. Hepatic involvement and renal involvement were seen significantly higher among leptospirosis patients.Conclusions: This study emphasized the importance of prophylactic doxycycline and early initiation of antibiotics during flood outbreaks. Awareness among treating doctors and patients is required for the control of outbreaks and prevention of mortality during floods.
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