Sonographic findings in grade III dengue hemorrhagic fever in adults

Abstract

Purpose Sonography has been used to evaluate children with dengue hemorrhagic fever, but to our knowledge no such studies have been conducted with adults. We present the sonographic findings in 40 adults with severe (grade III) dengue hemorrhagic fever (DHF). Methods Forty patients (30 men and 10 women, aged 16–65 years) given a presumptive diagnosis of grade III dengue hemorrhagic fever during a documented regional epidemic underwent abdominal sonography. Ten also underwent chest radiography. Serologic confirmation was obtained in 5 patients, and in the rest the diagnosis was based on epidemiologic and clinical findings. Results Sonographic findings included pleural effusion in 21 patients (53%), thickening of the gallbladder wall in 17 (43%), and mild ascites in 6 (15%). These findings were similar to those of previous studies of severe DHF in children, although the incidence of pleural effusion and ascites was slightly lower in our series. Neither pleural effusion nor ascites was apparent on clinical examination. Of the 10 patients who underwent both sonography and chest radiography, sonography detected pleural effusion in all 10, whereas radiography detected it in only 3. Conclusions Sonographic findings in DHF in adults (pleural effusions, ascites, and gallbladder wall thickening) were similar to those described for children but seem to be of lesser severity. Abdominal sonography is a useful diagnostic tool for confirming suspected cases of DHF. Sonography was found to be superior to chest radiography in detecting pleural effusions in the 10 patients in whom radiographs were available. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:34–37, 2000.

Dengue Fever in Children: Role of Ultrasonography.

“…The diagnosis of DF is often delayed owing to time taken for availability of serology test results [14]. Ultrasonography (USG) is a cheap, rapid and widely available non-invasive imaging method [15,16]. Some authors concluded findings of hepatomegaly, pericholecystic edema, thickened gall bladder, ascites, pleural effusion (right sided/ both) and splenomegaly are early and significant markers of dengue, which can be confirmed by serology later on [17,18].…”

“…In a study by Quiroz-Moreno et al [33] gallbladder thickening was seen in 86% of the patients, Sai et al [14] observed in 56% patients whileThulkar et al in 35.1% [34]. Setiwan et al attempted to investigate whether gall bladder wall thickening measured by ultrasonography can be used to predict the onset of severe dengue fever.…”

Acute Acalculus Cholecystitis in Dengue Hemorrhagic Fever-A Case Report

“…9 Abdominal sonographic findings in DF are a thickened gallbladder wall, ascites, splenomegaly and pleural effusion. 10 Contrary to this, some authors have described a typical reticular pattern of gall bladder wall thickness that can be used to diagnose and follow up patients with severe DF but should not be considered as an acalculus cholecystitis. 11 Acalculous cholecystitis should be suspected in patients infected with dengue complaining of abdominal pain.…”

A case of acalculous cholecystitis in the course of dengue fever in a traveller returned from Brazil

“…The thickening of gallbladder wall is the most frequent (43-59%) ultrasonographic finding in patients with dengue fever [15,16] whereas in the case of dengue haemorrhagic fever it may be found in up to 90% of patients [17][18][19][20]. The condition occurs in 7.6% to 38% of patients [9,21,22].…”