An epidemic of dengue haemorrhagic fever and dengue shock syndrome in Delhi: a clinical study

Srivastava, V. K.; Suri, Shivali; Bhasin, Ashu; Srivastava, Lara; Bharadwaj, Mohan

doi:10.1080/02724936.1990.11747453

Cited by 48 publications

(32 citation statements)

References 5 publications

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“…14,15 Various other factors apart from thrombocytopenia lead to bleeding manifestations, which are decreased platelet function, fibrinogen consumption, prolongation of PT/PTT, and vasculopathy. 16 Hepatomegaly was observed in majority of cases of severe dengue in our study, as reported in studies of Joshi R, Srivastava VK et al 17,18 55% of cases in our study had raised haematocrit, with only 7 cases of severe dengue fever. But findings of Agarwal et al reported much lower incidence of cases with raised haematocrit which does not coincide with our findings.…”

Section: Discussionsupporting

confidence: 72%

Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India

Sharma

Balasubramanyam

Kandati

et al. 2016

Int J Contemp Pediatr

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Background: Dengue fever is a mosquito borne arboviral disease which is of global concern. It is endemic in tropical countries with annual incidence of 7.5 to 32.5 million cases. It commonly affects the young adults and paediatric cases of Dengue haemorrhagic fever has high mortality. The objective of this study was to assess the clinical and laboratory profile and outcomes of dengue fever in children of less than 18 years of age. The study was conducted for a period of one year during an outbreak, in a tertiary care hospital of Chennai, Tamilnadu, India.Methods: This was a prospective cross sectional study and 200 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire form. Haematological parameters were recorded and followed till the day of discharge. The duration of stay was recorded and outcomes were noted.Results: A total of 200 cases with 113 males and 87 females, 177 non severe dengue cases and 23 severe cases of dengue fever were classified. The mean age of admission was 9 years and mean duration of stay in hospital was 4.61 days. Fever was most common presenting symptom (100%) and hepatomegaly (58.5%) was common clinical finding. Bleeding manifestations were seen in severe dengue cases. Statistical significance was seen in rise in SGOT levels, rise in haematocrit and pleural effusion with severe dengue cases and non-severe dengue cases. The case fatality rate was zero.Conclusions: Understanding the knowledge of presentations and associated features would help to predict the severity of the disease. In children, if symptoms like fever, pain, rashes, and vomiting are associated with Hepatomegaly and elevated SGOT in context of low total platelet count, 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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Section: Discussionsupporting

confidence: 72%

Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India

Sharma

Balasubramanyam

Kandati

et al. 2016

Int J Contemp Pediatr

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“…However, no correlation was possible between prolonged PT, APTT and prognosis. Hypoalbuminemia was seen in 38.0% and comparable to previous sudy by Srivastava et al; higher percentage (76.0%) of hypoalbuminemia was reported by Aggarwal A et al 31,35 Mishra S et al report the prevalence of DHF to be 13.4% (n=13) in their paediatric patients, with greater affliction in >11 years (n=09). 36 There were more number of males (n=09) with severe dengue.…”

Section: 12-14supporting

confidence: 70%

Clinical and diagnostic features of dengue haemorrhagic fever in children

Reddy

Nagendra

2018

Int J Contemp Pediatr

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Background: Diagnosis of dengue hemorrhagic fever (DHF) in children is based on clinical suspicion and prompting laboratory criteria.Methods: This prospective study in children (6 months-14 years) presenting with features of DHF aimed to identify symptoms and signs, laboratory parameters for in early detection and assessed the association between clinical, laboratory, immunological parameters and outcome.Results: Of 50 children, 26 were females, mean±SD age was 8.3±3.02 years; age group 8-12 years were affected the most (38.0%) and infants the least (4.0%). Fever (100%), followed by skin rash (56.0%), myalgia (52.0%) and head ache (48.0%) were the symptoms. Fever of 4-5 days (52.0%), high grade fever (84.0%) and of sudden onset (76.0%) were common. Ascitis was seen in nine. Peteche and malena (48.0%) were predominant manifestation of bleeding tendency (100%). Positive tourniquet test (48.0%) did not correlate with bleeding tendency. Lower levels of Hemoglobin (<12gms%, 100%), hematocrit (<40%, 98.0%), platelet count (<100000/mm3, 100%), serum albumin (76.0%), and abnormal liver enzymes (64.0%) along with prolonged prothrombin time (44.0%) and aPTT (18.05%) were noted. Ultrasound abdomen confirmed Pleural effusion (52.0%), ascitis (22.0%), Hepatomegaly (68.0%). Mean detection time was 4 days. Positive dengue IgM and IgG (60.0%), IgM (16%), and IgG (24%) were observed with increase of IgM in early phase.Conclusions: lower platelet count, raising haematocrit, increased liver enzymes with low serum albumin levels are early indicators. Prolonged PT and APTT are associated with severe bleeding manifestations. Apart from clinical expertise, chest X-ray, abdominal ultrasonogram are useful diagnostic tools.

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“…In the study by Srinivas et al [26], fever and vomiting were the most frequent symptoms. Similar observation was also seen in earlier studies [14,28,29]. Srinivasa also observed rashes in 10.5% cases while Ahmed FU et al [30] noted rashes in 12% of children.…”

Section: Discussion:-supporting

confidence: 77%

Dengue Fever in Children: Role of Ultrasonography.

Mulay¹

2017

IJAR

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Introduction: Dengue fever is one of the most important emerging vector-borne viral diseases. There are four serotypes of dengue viruses, each of which is capable of causing self-limited dengue fever or even life-threatening dengue haemorrhagic fever and dengue shock syndrome. The aim of this study was to evaluate the role of sonographic findings as early diagnostic modality in children with dengue fever. Materials & Methods:This cross-sectional observational study was carried out in the department of pediatrics of a tertiary care hospital. A total of 88 patients who were clinically and serologically (NS1 antigen/ IgM/ IgG antibody) diagnosed as dengue positive were included in this study.These patients also underwent USG abdomen and chest within the first week of the illness. Results: Out of the 88 confirmed dengue cases,56 (63.6%) cases were males. All the cases had fever (100%). Other clinical symptoms were vomiting in 64.8%, abdominal pain in 62.5%,bodyache 53.4%, Shock in 28.4%, headache in48.9% and rashes in 23.9%.The USG findings were hepatomegaly (39.8%), gall bladder thickening (53.4%), splenomegaly (20.5%), pleural effusion (38.6%) and ascites (30.7%).Overall 65 (73.8%) out of 88 cases had one of the positive finding in ultrasonography. Conclusion: Ultrasonography can be used as a first-line imaging modality in all patients with suspected dengue fever to detect early signs suggestive of the disease.

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An epidemic of dengue haemorrhagic fever and dengue shock syndrome in Delhi: a clinical study

Cited by 48 publications

References 5 publications

Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India

Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India

Clinical and diagnostic features of dengue haemorrhagic fever in children

Dengue Fever in Children: Role of Ultrasonography.

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