Clinical spectrum of dengue at a tertiary care hospital in Eastern India

Abstract

Background: Dengue is a vector borne disease by four different serotypes of dengue virus transmitted by bite of female Aedes mosquito. It is an acute febrile illness characterised by myalgia, joint pain, gastrointestinal manifestations. Complications like dengue hemorrhagic fever (DHF) and Dengue shock syndrome (DSS) , Extended Dengue Syndrome(EDS) may be fatal for patients. Authors analyse different clinical spectrum of of manifestations, complications and correlation bleeding to platelet level.Methods: This study conducted from July 2017 to December 2018 comprising of 100 dengue patients of age more than 15 years in IMS & SUM Hospital.Result: Out of 100 dengue patients’ males 73% and females 27%. From the patients 57% were NS1 Antigen positive, 29% IgM positive, 9% NS1 and IgM positive, 4% IgM and IgG positive and 2 % with all NS1, IgM, IgG positive. In our series in clinical manifestations, all cases (100%) presented with fever, myalgia (78%), headache (53%), rashes (14%), nausea, pain abdomen (21%) loose motion (17%), and Retro-orbital pain (6%). Bleeding manifestations in any form was seen in 39% cases like Purpura or Petechie (23%), malena (18%), hematemesis ( 2% ), epixtasis (6%), Gum bleeding (2%), Hematuria (1%), and Ophthalmic bleeding like sub conjunctival hemorrhage, intra-vitreal hemorrhage in 8% cases. Complications detected e.g. hepatopathy in 53%, nephropathy. 4%, ascites 8%, pneumonia 7%, DSS (4%), Multi Organ Dysfunction (MODS) (4%), DHF (8%) and EDS in 2% cases. It was observed that 95.8% of patients with platelet counts between 20,000-50,000/cu.mm and 61% of patients less than 25000 had bleeding manifestations.Conclusion: Wide clinical spectrum of manifestations and complications makes it common differential diagnosis of acute febrile illnesses and bleeding manifestation does not always corelate with lower platelet count.

Severe ocular and adnexal complications in dengue hemorrhagic fever

“…Setting its foot in the Indian subcontinent in the 1940s, the epidemiology and serotypes of dengue virus in India seem to be constantly evolving posing a threat to the community and a challenge to the medical fraternity. [ 1 2 3 4 5 6 7 ]…”

“…Dengue is an important health problem in India with the numbers on the rise. [ 1 2 3 4 5 6 7 8 ] Ophthalmic complications have earlier been known to occur in the form of anterior uveitis, panuveitis, retinitis, sub-hyaloid hemorrhage, retinal hemorrhages, maculopathy, neuororetinitis, optic neuropathy, and corneal epitheliopathy. [ 9 10 11 12 13 14 15 16 17 18 ] Notably, over the past decade, the disease has manifested in a severe form of ocular and orbital involvement with the scleral melt, necrotizing scleritis, globe rupture, endophthalmitis, and panophthalmitis.…”