Clinical and Laboratory Profile of Dengue Fever In a Tertiary Care Centre

medical

Abstract: To study the clinical profile and outcome of the manifestations of dengue fever in children. Methods All children (0–12 y of age) diagnosed and confirmed as dengue fever at a tertiary care hospital at Bangalore, between the 1st of November 2018 and March 31st 2019 were reviewed retrospectively from hospital case records as per the revised World Health Organization (WHO) guidelines. The diagnosis was confirmed by NS1 antigen based ELISA test or dengue serology for IgM and IgG antibodies. Results Out of 60 children admitted with dengue fever. Mean age of presentation was 6.9(3.3) y. M: F ratio was 1.2:1. The common manifestations of severe dengue infection were shock (37.4 %), bleeding (20.1 %) and multiorgan dysfunction (2.4 %). The most common atypical manifestations of dengue fever were lymphadenopathy (41.7 %),splenomegaly (21.2 %), biphasic fever (18.1 %), hepatitis (11.4 %), febrile diarrhea (6.3 %), refractory shock (2.4 %)and impaired consciousness (1.9 %). The other atypical manifestations present were portal hypertension, acalculous cholecystitis, appendicitis, acute respiratory distress syndrome(ARDS), myocarditis, pericardial effusion, paroxysmal supraventricular tachycardia (PSVT), myositis, acute kidney injury(AKI), hemophagocytic syndrome and disseminated intravas cular coagulopathy (DIC). Platelet count did not always correlate well with the severity of bleeding. There were six deaths(2.4 %) and out of them four presented with impaired consciousness (66.6 %). The common causes for poor outcome were multiorgan failure, encephalopathy and refractory shock.Conclusions The atypical manifestations of dengue fever are no more a rare entity. Clinicians should have a high index of suspicion and vigilance for atypical manifestations of dengue fever as lack of timely detection and management could be fatal. Impaired consciousness was the most ominous atypical manifestation of severe dengue infection.

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