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.