Effect of dengue fever on the total leucocyte count and neutrophil count in children in early febrile period

Abstract

Introduction: Dengue is an arboviral disease caused by flavivirus. In India, the incidence of dengue fever is on a rise every year. The course of illness is different for each patient. Therefore early measurement of laboratory parameters can guide to the management of the disease. Aim of the study: 1) To study the effect of dengue fever on the total leucocytecount (TLC) in children in early febrile period. 2) To determine the neutrophil count in early stage of dengue fever. Study design: Observational study. Methodology: Patients of 1-14 years age group, who presented with fever of recent duration were included in the study. About 80 patients with early manifestations (1-5 days) of fever were included. Dengue was suspected in 55 children who had two or more of the following symptoms-fever, pain abdomen, headache, myalgias, arthralgias, skin rash, nausea, vomiting, retroorbital pain, prostration. Out of these 55 children, 50 children who presented in early febrile period (1-5 days) and who were serologically positive for denguetook part in the study. Blood investigations were done for total leucocyte count (TLC) and neutrophil count.Results: About 26% of the patients had leucopenia (<4000), 66% had leucocyte count in normal range (4,000-11,000) and only 8% had leukocytosis (>11,000). About 34 (68%) patients had neutrophil count of less than 40% and 16 (32%) patients had neutrophils between 40 to 80%. Conclusion: In early febrile period of dengue fever, majority have normal white blood cell count. Any change in the values of total leucocyte count points towards the progression of the disease towards severity. There is neutropenia in most of patients in dengue fever. Presence of neutropenia merely doesn't determine the use of antibiotics.

Altered Electrolyte Homeostasis and the Severity of Dengue in Children

“…Ralapanawa et al reported 70.9% of the patients had WBC count of <50000 in dengue fever 27 . On the contrary, leucopenia was observed in only 32% of the patients in our study, which was supported by the study of Khandelwal and colleague that the majority of the patients had WBC count within the normal range during the early febrile period of the disease and change in leukocyte count show progression towards severe disease 28 .…”

Nucleoside Analogs with Selective Antiviral Activity against Dengue Fever and Japanese Encephalitis Viruses

“…Hallmark features of human DHF/DSS are vascular leakage, greater viral burdens, elevated serum cytokine levels, hypotension, and thrombocytopenia (27,28). Although leukopenia is a common feature found in patients with DENV infections, normal white blood cell counts or leukocytosis may also occur during DENV infections, as observed in experimental models (19,20) and in children (30). Here we showed that compound 10 delivered as a preventative (day 0) or therapeutic (day 2 postinfection) modality prevented loss of body weight, mitigated viral induction of inflammation, ameliorated leukocytosis induced by infection, especially by reduction of circulating neutrophil levels, and protected against hepatic edema.…”

Dengue: A Neglected Disease of Concern

“…The total leucocyte count was significantly low in dengue without warning signs and severe dengue compared to dengue with warning signs. The change in total leucocyte count predicts the progression of dengue, as reported by Khandelwal and Khandelwal [16]. No correlation was seen between leucopenia and the severity of dengue and its complications by Jayanthi and Tulasi [17].…”