Clinical and Laboratory Profile of Dengue Fever

Abstract

AIM: Dengue is a major health problem in many parts of India and Gulbarga (North Karnataka) was previously not a known endemic area for dengue. Infection with dengue virus can cause a spectrum of three clinical syndromes, classic dengue fever (DF), dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The present study was undertaken to determine the disease profile of dengue virus infection in hospitalized patients. METHODS AND MATERIAL: One hundred patients admitted in Basaveshwar Teaching and General hospital with fever more than 38.5 degree Celsius and IgM dengue positive were selected. They were followed from the onset of fever to twelve days or till they are recovered according to WHO discharge criteria whichever is earlier. They underwent relevant investigations to identify specific organ dysfunction and categorize them into the spectrum of Dengue fever in accordance to WHO criteria. RESULTS: Out of 100 cases in this study 70 cases belongs to DF, 23 cases to DHF and 7 cases to DSS based on WHO criteria. All the cases had fever (100%). Other common symptoms noted were myalgia (61%), joint pain (54%), headache (66%), vomiting (55%), pain abdomen (48%), rash (41%), hepatomegaly (20%), bleeding (21%) and shock (8%). Hess test was positive in 24% patients. Low platelet count of less than 100, 000/cu mm according to WHO criteria was present in 73% patients. Deranged liver function test and renal parameters were seen in 26 and 8 patients respectively. Mortality documented was 7 patients due to delayed presentation. The average duration of hospital stay was 4.65 days. CONCLUSION: Dengue fever was a more common manifestation than DHF or DSS. During aepidemic, dengue should be strongly considered on the differential diagnosis of any patient with fever. The treatment of dengue is mainly fluid management and supportive. Early recognition and management of alarm symptoms is the key to better outcome.

A study of hematological profile in dengue fever at tertiary care center, Kota Rajasthan, India

“…Studies by, Singh NP et al Khan E et al and Farhan F et al showed the incidence of thrombocytopenia in 61.39%, 67.2%, 73% respectively which is lower than present study. 6,7,9 In present study hematocrit ranged from 20% to 51%. The mean hematocrit value of dengue positive cases in our study was 39.08%.…”

“…Observation made by Farhan F et al bleeding was seen in 21% cases which are higher than present study. 6 In present study severity of thrombocytopenia was associated with increased incidence of bleeding. Khan et al also found that bleeding was related to the severity of thrombocytopenia as 80% of patients having platelet count lower than 25,000/μl Showed bleeding manifestation.…”

“…Observations made by Farhan F et al showed that majority of patients i.e., 30% were in age group of 21-30 years which is almost similar to the present study. 6 Singh NP et al also showed mean age of 26±10 years in their study. 7 This may be due to young adults are being more active outside from the home.…”

“…Other studies by Singh NP et al, Neerja M et al and Farhan F et al observed sex ratio of 3.02:1, 2:1, 0.98:1 respectively. 4,6 In present and other study showed that the incidence of malaria is more common in males than females this is because males are more frequently exposed to the risk of acquiring malaria than females because of their outdoor life which they lead. Further, female in India are usually better clothed than males, hence they are less exposed.…”

“…Hematocrit <40% found in 54% patients in present study which is similar with study done by Farhan F et al and They found hematocrit value >45% in 19% patients. 6 In present study, hospital was a tertiary care level; mostly patients came here from other hospital with primary management with I.V fluid. So mostly patients were had normal range hematocrit.…”