Abstract:
Introduction: Dengue infections result in a disease continuum that includes syndromes varying in severity and prognosis. These include dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS), the most severe form of DHF. All are caused by dengue viruses that belong to the family Flaviviridae as four serotypes (DEN-1, DEN-2, DEN-3 and DEN-4)1,2. The exact clinical profile is important for patient management and thus crucial for saving life. The present study is an attempt to describe the salient clinical as well as laboratory findings of serologically confirmed hospitalized cases of dengue fever during the study period. The study group represented the adult population.
Aim and objectives
1. To study the clinical profile of recent of dengue epidemic cases
2. To evaluate the complications, outcome and follow up of Dengue patients.
MATERIAL AND METHODS: Patients with dengue fever (sero positive) with or without thrombocytopenia admitted to medical wards of S. P. Medical College& Associated Group of P. B. M. Hospitals Bikaner.
Inclusion criteria
• Age more than 16 years
• Proven case of dengue fever by NS1, IgM, or IgG antibody
• A written consent given by patient
Exclusion criteria: Other causes of fever with thrombocytopenia like malaria, brucellosis, leptospira, and enteric fever.
Sample size: 200 cases.
Results: Out of total 200 patients, 173(86.5%) patients had classical dengue fever, 23(11.5%) had dengue haemorrhagic fever while only 4(2%) patients had dengue shock syndrome. A total of 151 (75.5%) patients were male and 49 (24.5%) were females with a male to female ratio of 3:1. All(100%) of the patients presented with fever. All patients were admitted with history of fever, majority of patients had their duration of fever between 2-6 days. The other symptoms observed were arthralgia (80%), backache (87%), headache (94.5%), nausea or vomiting (72.5%) and abdominal pain (72%). The skin rash was present in (8%) cases and pruritus in 25% cases and 69 (34.5%) patients had pleural effusion and out of them 61 and 8 patients had their platelet count <50000/cmm, 50000-1 lakh/cmm respectively and the difference was found statistically highly significant (p<0.001) and ascites was present in total 48 patients and out of them 42 patients had their platelet count <50000/cmm and remaining 6 patients had their platelet count 50000-1 lakh/cmm and the difference was found statistically highly significant (p<0.001).
Conclusion: In our study 200 serologically confirmed cases of dengue viral infection, majority of the patients were in adult age group. There was male preponderance with male to female ratio of 3:1. Most of the cases belonged to classical dengue fever with 11.5% cases of dengue hemorrhagic fever and only 2% cases of dengue shock syndrome. All the patients had fever and constitutional symptoms like backache, arthralgia, headache, vomiting, abdominal pain etc. Fifteen percent patients had evidence of spontaneous hemorrhagic manifestations with hemoptysis, epistaxis or hematuria. Evidence of plasma leakage in the form of ascites and pleural effusion was present in 34.5% and 24% cases respectively. All the patients improved with symptomatic and conservative treatment and no mortality was noted in the study showing a favourable outcome. Follow up of cases after 4 weeks showed no incidence of readmission or any adverse complications and dropouts were noted due to reluctance of patients for follow up study as they were perfectly healthy and few could not be contacted.