Study of clinical and laboratory predictive markers of dengue fever and severe dengue in children
Abstract
Introduction: Dengue fever is the most rapidly spreading arboviral infection with major public health consequences. Leucopenia, thrombocytopenia, hematocrit, elevated aminotransferases, low CRP and prolonged APTT, are useful predictive markers for early diagnosis of dengue infection.
Objectives of the study: To study the clinical presentation and laboratory predictive markers of dengue fever, dengue with warning signs and severe dengue.
Materials and Methods: Prospective hospital based study of 100 patients who were classified as dengue (DF), dengue fever with warning signs (DWS) and severe dengue (SD). Lab investigations included WBC count, Platelet count, Hematocrit, SGOT, SGPT, PT, APTT, INR, CRP. Clinical and laboratory parameters in the 3 groups of dengue fever were compared in the study.
Results: Study group included 100 cases of which DF was 36%, DWS 52% and SD 12%. Commonest presenting symptom was fever, nausea and vomiting. Pain abdomen, hepatomegaly, splenomegaly, bleeding, jaundice were seen in DWS and SD group.
Lab parameters: Mean WBC count was low to normal in all 3 groups. Platelet count was low in all groups. Hematocrit, SGOT/SGPT, PT /APTT/INR was progressively found to be increased in the 3 groups. Low CRP was found in all 3 groups.
Conclusion: Reliable diagnosis of dengue fever in endemic areas can be done by clinical parameters like presence of nausea, vomiting, pain abdomen and hepatomegaly. Ascites, pleural effusion, shock, liver dysfunction and hemorrhage are the markers for severe dengue. Monitoring platelet count, hematocrit and WBC count is very useful for management of dengue cases.
Downloads
References
World Health Organization. Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Haemorrhagic Fever, WHO, 2011: www.searo.who.int>SEAROTPS60 (accessed on 8th October 2015)
Hand book for Clinical Management of Dengue, WHO July 2012:www.wpro.who.int>mvp>documents.(accessed on 15th January 2017).
Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N, Viramitrachai W, Ratanachu-eke S, Kiatpolpoj S, Innis BL, Rothman AL, Nisalak A, Ennis FA. Early clinical and laboratory indicators of acute dengue illness. J Infect Dis. 1997 Aug;176(2):313-21.
Guzmán MG, Kourí G. Dengue diagnosis, advances and challenges. Int J Infect Dis. 2004 Mar;8(2):69-80.
Baskar C, Babu ASKK, Anandan H. Clinical Profile and Outcome of Dengue Fever in Pediatrics.2016;5(10):79-81.
Surangrat Pongpana, Apichart Wisitwong, Chamaiporn Tawichasri, Jayanton Patumanond Prognostic Indicators for Dengue Infection Severity, Int J Clin Pediatr • 2013;2(1):12-18. Doi: http://dx.doi.org/10.4021/ijcp73w.
Ho et al.: Clinical and laboratory predictive markers for acute dengue infection. Journal of Biomedical Science 2013; 20:75. doi:10.1186/1423-0127-20-75.
National Guidelines for Clinical Management of Dengue Fever. WHO, 2014. www.nvbdcp.gov.in (accessed on 10th Feb 2017).
Jain H. Clinical profile and outcome of dengue fever in hospitalized children of South Rajasthan, India. Int J Contemp Pediatr 2016; 3(2):546-9. DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20161035.
Saraswathy MP, Sankari K, Sakthi Gnanavel, Sripriya Dinesh, Lakshmi priya. Incidence of dengue hemorrhagic fever in children: A report from Melmaruvathur Tamilnadu. J Pharm Sci Innov.2013;2 (1):34-6.
Bhave S, Rajput C S, Bhave S. Clinical profile and outcome of dengue fever and dengue hemorrhagic fever in pediatric age group with special reference to WHO guidelines(2012) on fluid management of dengue fever. International Journal of Advanced Research 2015; 3 (4):196-201.
Bokade C M., Chauhan U, Kamat P. Study of Hepatic Dysfunction in Dengue Fever and It’s Predictor of Outcome. Int J Recent Sci Res.2016;7 (9), pp. 13360-3.
Bandyopadhyay D, Chattaraj S, Hajra A, Mukhopadhyay S, Ganesan V. A Study on Spectrum of Hepatobiliary Dysfunctions and Pattern of Liver Involvement in Dengue Infection. J Clin Diagn Res. 2016 May;10(5):OC21-6. doi: 10.7860/JCDR/2016/16946.7784. Epub 2016 May 1.
Chaturvedi UC, Nagar R. Dengue and dengue haemorrhagic fever: Indian perspective.J Biosci. 2008 Nov;33(4):429-41.
Saha AK, Hazra SC, Chatterjee S, Maitra S. Clinico-pathological parameters predicting hemorrhage in Dengue fever in Pediatric patients of Kolkata. Transworld Medical Journal. 2013;1(4):116-120.
Gupta V, Yadav TP, Pandey RM, Singh A, Gupta M, Kanaujiya P, Sharma A, Dewan V. Risk factors of dengue shock syndrome in children. J Trop Pediatr. 2011 Dec;57(6):451-6. doi: 10.1093/tropej/fmr020. Epub 2011 Mar 2.
Chacko B, Subramanian G. Clinical, laboratory and radiological parameters in children with dengue fever and predictive factors for dengue shock syndrome. J Trop Pediatr. 2008; 54(2):137-140.
Alam K, Sulaiman SAS, Shafie AA, Yusuf E. Clinical manifestations and laboratory profile of dengue fever among the patient’s general Hospital, Penang. Arch Pharma Pract. 2010;1(1):25-29.
Karyanti MR. Clinical manifestations and hematological and serological findings in children with dengue infection. Paediatr Indones. 2011;51(3):157-162.
Selvan T, Saravanan P, Nagaraj MV, Tudu MN. Study of hepatic dysfunction of dengue fever in children. Int J Contemp Pediatr 2017;4: 901-4. DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20171695.
Srinivasa S, Tanveer Nawab, Chaithanya C Nair. Clinical profile and ultasonogaphic findings in children with dengue fever. Curr Pediatr Res 2014; 18 (2): 87-90.
Jagadishkumar K, Jain P, Manjunath VG, Umesh L. Hepatic involvement in dengue Fever in children.Iran J Pediatr. 2012 Jun;22(2):231-6.
Selvan T, Purushotham D R, Swamy N, Giridhar, Kumar M, Suresh et al. study of prevalence and hepatic dysfunction in dengue fever in children. Sch.J.App.Med.Sci.,2015;3(5D):2071-4.
Copyright (c) 2017 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
