Evaluation of Ultrasonographic Findings in Dengue Fever Cases during an Outbreak at a Tertiary Care Hospital of South India

Manam, Gayatri; Godavarthi, Ravi M; Baru, Ramakrishna; Sunitha, Sunitha; Duddu, Gowtham Surya

doi:10.21276/ijcmsr.2018.3.2.26

Cited by 4 publications

(4 citation statements)

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“…In our study, mean value of platelets in patients with GBWT is 48. [21][22][23][24]. According to our study results, hematocrit shows no statistically significant association with GBWT (p=0.258), which is in line with the recent evidence that hematocrit is a poor indicator of the severity of dengue infection [25].…”

Section: Discussionsupporting

confidence: 85%

“…In our study, mean value of platelets in patients with GBWT is 48.1 ± 17.3 x103 cells/µl (p-value <0.001). Manam G et al, Bajaj S et al, and Nagolu H et al support this fact statistically; however, Tavares MdA et al show no association of GBWT with platelet count or other hematological parameters [ 21 - 24 ]. According to our study results, hematocrit shows no statistically significant association with GBWT (p=0.258), which is in line with the recent evidence that hematocrit is a poor indicator of the severity of dengue infection [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

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Gall Bladder Wall Thickening in Dengue Fever – Aid in Labelling Dengue Hemorrhagic Fever and a Marker of Severity

Adil

Rabbani

Ahmed

et al. 2020

Cureus

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Introduction Dengue fever is a mosquito-borne viral disease spread by the bite of the Aedes aegypti mosquito. Dengue epidemics have contributed to a great economic burden, especially in SouthEast Asia. This study aimed to determine gall bladder wall thickness (GBWT) in patients with dengue fever, assess its sensitivity and specificity to identify dengue hemorrhagic fever, and also compare gall bladder wall thickening (GWBT) with platelets, hematocrit, and leucocyte count. Materials and methods This prospective observational study was conducted in the dengue ward of Benazir Bhutto Hospital, Rawalpindi, Pakistan, from September 2019 to January 2020, i.e., four months. Patients admitted to the dengue ward diagnosed as seropositive and provided consent were enrolled into the study. Laboratory investigations (blood complete picture, liver function tests, renal function tests) were collected and recorded. Ultrasonography was performed on admission and subsequently during a hospital stay. Patients were divided into two groups: those with gall bladder wall thickness ≤ 3mm and ˃3mm. All data were entered and analyzed on SPSS version 24 (IBM Inc., Armonk, USA). Results Out of 180 patients, 122 (67.8%) were male, and 58 (32.2%) female. The mean age was 33 ± 13 years. One hundred and six patients (58.9%) were diagnosed with dengue fever, 68 (37.8%)-dengue hemorrhagic fever, and six (3.3%)-dengue shock syndrome. The most common finding was gall bladder wall thickness ˃3mm (69/180; 38.3%) followed by ascites (38.1%). Sixty-two patients out of 69 (89.9%) with GBWT ˃3mm were managed as dengue hemorrhagic fever (p=0.000). Alanine transaminase (ALT), platelet, and total leukocyte count (TLC) were associated positively with an edematous gall bladder wall (p<0.005). The mean gall bladder wall thickness for dengue hemorrhagic fever was 6.4mm ± 2.5 mm. A GBWT value of 3.5mm was found to have 94.6% specificity and 91.2% sensitivity. Conclusion Gall bladder wall edema is strongly correlated with dengue hemorrhagic fever. Hence it should be assessed in all patients with dengue fever.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Gall Bladder Wall Thickening in Dengue Fever – Aid in Labelling Dengue Hemorrhagic Fever and a Marker of Severity

Adil

Rabbani

Ahmed

et al. 2020

Cureus

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“…Other studies Fig. 1 The gallbladder wall is thickened, appearing as though the wall has separated looks with striated structure in between have quoted the incidence ranging from 32% to as high as 89.2% [11][12][13][14]. There was no mortality reported in our patients.…”

Section: Discussionsupporting

confidence: 46%

The association of ultrasound assessment of gallbladder wall thickness with dengue fever severity

et al. 2022

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Objectives To evaluate the association between ultrasound assessment of gallbladder wall thickness (GBWT) among severe dengue patients and dengue patients with warning signs to their clinical outcomes. Methods A prospective, cross-sectional study involving adult dengue patients presented to our emergency department between March until September 2018. The patients were classified based on WHO classification. A gallbladder wall scan was performed on all patients. Results A total of 44 patients were enrolled into the study; majority of the patients with GBWT had severe dengue, significantly more than the dengue patients with warning signs (90.5% sensitivity; 69.6% specificity). The sensitivity of GBWT in determining admission to critical care areas or general ward was 100% with a specificity of 62.1%. Our analysis showed that the two variables significant in determining the severity of dengue were age (p = 0.045) and GBWT (p < 0.001). Both factors together gave 81.0% sensitivity and 78.3% specificity in predicting patients for severe dengue. The receiver operator characteristic curve revealed that using variable GBWT status can discriminate 87.1% (95%CI 66.3, 93.7%) of having severe dengue or dengue with warning signs. Conclusion The finding of GBWT when consolidated with other clinical parameters may assist clinicians to perform risk stratification in the emergency department and become another adjunct to the assessment of severe dengue.

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“…Other modalities with a high yield in PEM POCUS include the diagnosis of intussusception, and identification of soft tissue foreign bodies . In environments with a high incidence of communicable diseases, sonologists use the FASH examination to screen for suspected TB effusions, assess for oedematous states in dengue patients to guide fluid management and identify patients at high risk for deterioration, and assess the presence and degree of hepatomegaly or splenomegaly in patients with malaria.…”

Section: Discussionmentioning

confidence: 99%

Paediatric point‐of‐care ultrasound in a resource‐limited Melanesian setting: A case series

Henry

2020

Australas J Ultrason Med

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Point‐of‐care ultrasound (POCUS) is an imaging modality with high potential impact on the practice of paediatric emergency medicine in resource‐limited settings. Aside from the obvious diagnostic utility, it facilitates safe procedural guidance at the bedside and provides haemodynamic information to guide resuscitation of shocked states. This five‐patient paediatric case series illustrates the range of POCUS modalities used while working in emergency medicine at a regional referral hospital in Vanuatu. Cases described include a teenager with meningococcaemia, femoral central line insertion in an infant, ventricular septal defect in an infant, a child with a leg abscess, and a child with rheumatic heart disease.

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Evaluation of Ultrasonographic Findings in Dengue Fever Cases during an Outbreak at a Tertiary Care Hospital of South India

Cited by 4 publications

References 5 publications

Gall Bladder Wall Thickening in Dengue Fever – Aid in Labelling Dengue Hemorrhagic Fever and a Marker of Severity

Gall Bladder Wall Thickening in Dengue Fever – Aid in Labelling Dengue Hemorrhagic Fever and a Marker of Severity

The association of ultrasound assessment of gallbladder wall thickness with dengue fever severity

Paediatric point‐of‐care ultrasound in a resource‐limited Melanesian setting: A case series

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