Atypical Manifestations of Dengue Fever – Where Do We Stand Today?

Nimmagadda, Satya Sudhish; Chakrapani, M; Boloor, Archith; Raghuram, Pavan Manibettu; Nayak, Unnathi

doi:10.7860/jcdr/2014/6885.3960

Cited by 39 publications

(51 citation statements)

References 8 publications

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“…*P < 0.05 previous studies, the incidence of dengue-associated acute liver failure ranged from 0.66% to 0.77%. 4,7 Therefore, our study revealed a lower incidence than found in previous studies. In the present study, the incidence of acute liver failure among patients with dengue was 3.1/1,000 patients, which is higher than that found in a previous study in Vietnam (1.5/1,000 patients with dengue).…”

Section: Discussioncontrasting

confidence: 63%

“…Acute liver failure secondary to dengue is rare but has a high mortality rate. 4 Acute liver failure is defined as the rapid onset of acute encephalopathy and coagulopathy in a patient without preexisting cirrhosis and with < 26-week duration of illness. 5,6 Severe hepatic involvement (acute liver failure) is a rare condition in patients with dengue, but commonly occurs during the second week of illness.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Clinical Outcome of Acute Liver Failure Caused by Dengue in a Hospital for Tropical Diseases, Thailand

Mon

Nontprasert

Kittitrakul

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Acute liver failure is an atypical manifestation of dengue with a high mortality. We performed a retrospective cohort study at the Hospital for Tropical Diseases, Bangkok, Thailand. In total, 1,926 patients with serologically confirmed dengue were enrolled in the study from 2011 to 2015. Of these, six patients presented with acute liver failure, four died, and two survived. The incidence of dengue-associated acute liver failure was 0.31%. Dengue-associated acute liver failure was most common among young adults (median age, 29 years). The median duration from onset of fever to development of acute liver failure was 7.5 days. Patients with the severe stage of dengue had a higher risk of developing acute liver failure (P < 0.001). The baseline risk factors associated with the development of acute liver failure were an age of ≤ 40 years (odds ratio [OR] = 1.5, 95% confidence interval [CI] = 1.1-2.0, P < 0.05), a > 10% ratio of atypical lymphocytes (OR = 2.3, 95% CI = 1.8-3.0, P < 0.001), and a platelet count of < 50,000 mm 3 (OR = 2.8, 95% CI = 2.2-3.6, P < 0.001). The incidence of acute liver failure in patients with dengue was quite low, but its impact on morbidity, mortality, and poor clinical outcomes was significant. In summary, this study indicates that various baseline risk factors are associated with acute liver failure in patients with dengue.

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Section: Discussioncontrasting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Incidence and Clinical Outcome of Acute Liver Failure Caused by Dengue in a Hospital for Tropical Diseases, Thailand

Mon

Nontprasert

Kittitrakul

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…However, when calculated for more than 3 times of normal for 47.5% raised ALT and 77.2% had raised AST. In a study by Nimmaggada et al (9) it was shown that raised liver enzymes were seen in 92.6% of cases. Overall, 92.7% of patients had Aspartate Transaminase (AST) > 40 U/L and three-fold increase was seen in 58.7%.…”

mentioning

confidence: 93%

Changing Trends in Clinical Presentation and Biochemical Spectrum of Dengue Fever: An Observation of a Tertiary Care Centre

Jain

Rajput

Pathak

et al. 2017

Arch Clin Infect Dis

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Objectives: Cases of dengue are on the rise and India experienced its worst epidemic during 2015. There was almost a 2 times rise in the number of cases. This study was done to understand the varied presentation and manifestation of dengue at a tertiary care centre of Haryana, India. Methods: This was an observational cross sectional study undertaken at PGIMS Rohtak, Haryana, India. One hundred and one patients aged ≥ 14 years, who had positive test results for dengue, as NS1/IgM, were included in the study. Clinical presentations, haematological, and biochemical markers were studied and analyzed. Results: Out of 101 patients, 63.3% were males. Overall, 95% had fever followed by headache (62.3%), rash (53.4%), retrorbital pain (43.5%), and abdomenal pain (43.5%). Furthermore, 31.8% of patients had bleeding manifestation, of which the commonest was petechiae (12.8%) followed by malena (7.9%) and bleeding gum (6.9%). All patients had raised liver enzymes. Platelet count of < 50,000/mm 3 was present in 79.2%. Leucopenia was found in 43.5% of patients. Ultrasonography suggestive of free fluid was found in 44.5%. Hypokalemia was seen in 21.7% of patients. Complications, such as acute respiratory distress syndrome (ARDS) and DIC, were seen in 2.9% and 5.9% cases. Overall mortality rate was 2.97%. Conclusions: Dengue could have varied presentations ranging from a simple febrile illness to fatal multiorgan failure. It is crucial to understand the features, which predict the progress of dengue fever (DF) to dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Considering that the treatment of dengue is relatively simple, early institution of appropriate therapy with close monitoring of vital signs and laboratory parameters could help prevent morbidity and mortality related to dengue.

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“…La frecuencia de compromiso de órganos encontrada fue de 18.1%, similar a la descrita en la serie de Salgado et al (7), constituyéndose en la segunda causa de DG, después del choque. La miocarditis, con 14 casos, ocupó el primer lugar dentro de las causas de organopatía, resaltando la importancia de su diagnóstico en dengue (7,14,15).…”

Section: Discussionunclassified

Análisis descriptivo del compromiso de órganos en niños con dengue grave en Neiva, Colombia

et al. 2017

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Análisis descriptivo del compromiso de órganos en niños con dengue grave en Neiva, Colombia Objective: To describe the affectation caused by dengue in organs such as the myocardium, the liver and the central nervous system (CNS) in children from Neiva, Colombia. Results: Out of 930 children, 105 were classified as severe dengue (SD) and, of these, 19 had affected organs. The myocardium was the most compromised organ (14 cases), followed by the liver (4 cases) and the CNS (1 case). Materials and methods: Conclusion:Clinical involvement of the myocardium, liver or CNS was observed in 18% of the cases of children with SD. A timely diagnosis and treatment of this pathology in children is necessary.

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Atypical Manifestations of Dengue Fever – Where Do We Stand Today?

Cited by 39 publications

References 8 publications

Incidence and Clinical Outcome of Acute Liver Failure Caused by Dengue in a Hospital for Tropical Diseases, Thailand

Incidence and Clinical Outcome of Acute Liver Failure Caused by Dengue in a Hospital for Tropical Diseases, Thailand

Changing Trends in Clinical Presentation and Biochemical Spectrum of Dengue Fever: An Observation of a Tertiary Care Centre

Análisis descriptivo del compromiso de órganos en niños con dengue grave en Neiva, Colombia

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