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. 2014 Jan;8(1):71-3.
doi: 10.7860/JCDR/2014/6885.3960. Epub 2013 Jan 12.

Atypical Manifestations of Dengue Fever (DF) - Where Do We Stand Today?

Satya Sudhish Nimmagadda  1 , Chakrapani Mahabala  2 , Archith Boloor  3 , Pavan Manibettu Raghuram  4 , Akshatha Nayak U  3
Affiliations

Atypical Manifestations of Dengue Fever (DF) - Where Do We Stand Today?

Satya Sudhish Nimmagadda et al. J Clin Diagn Res. 2014 Jan.

Abstract

Background and objectives: Dengue fever (DF) is transmitted by Aedes aegypti mosquitoes. With growing population, rapid urbanization and lack of appropriate sanitary measures, proliferation of mosquitoes and subsequent dengue infections have increased rampantly with an estimated 30-fold increase in incidence over last five decades. With rising disease burden, atypical manifestations have increased as well, which are missed most often due to lack of awareness. Our aim was to look for the atypical manifestations of dengue fever.

Materials and methods: A prospective hospital based observational study was conducted at hospitals of Kasturba Medical College in Mangalore over a period of two years (June-2010 to May-2012). One-hundred fifty ELISA confirmed IgM-dengue sero-positive cases satisfying WHO criteria were examined clinically and laboratory data assessed till they got discharged from hospital after ruling out other causes of fever. Atypical manifestations in dengue fever were noted and analyzed.

Results: Most common symptoms noticed were myalgia, headache, rash, arthralgia, pain in abdomen and nausea. More than half of the study group had one or the other atypical manifestation. Liver function test derangement was most often seen. Most common atypical manifestation was hepatitis found in 40.6% patients. Febrile diarrhea, renal failure, Acalculous cholecystitis and conduction abnormalities of heart were among other common manifestations. Three patients died of multi-organ dysfunction, disseminated intravascular coagulation and shock. Platelet count did not correlate well with severity of bleeding. Overall recovery rate was good.

Conclusion: Some of the atypical manifestations of dengue fever are no more a rare entity. Clinical vigilance for these manifestations is important for timely detection and management as some of them could be fatal.

Keywords: Aedes aegypti mosquitoes; Atypical manifestations; Dengue fever; Hepatitis.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Atypical manifestations ofdengue fever DIC - Disseminated intravascular coagulation, ALI - Acute lung injury, ARDS - Acute respiratory distress syndrome
See this image and copyright information in PMC

References

    1. World Health Organization, Regional Office for South-East Asia. Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Haemorrhagic Fever. Revised and expanded edition. WHO-SEARO 2011. (SEARO Technical Publication Series No. 60)
    1. Vaughn DW, Green S, Kalayanarooj S, Innis BL, Nimmannitya S, Suntayakorn S, et al. Dengue viremia titer, antibody response pattern, and virus sero-type correlate with disease severity. J Infect Dis. 2000;181:2–9. - PubMed
    1. WHO. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control, New edition, 2009. WHO Geneva. - PubMed
    1. Karoli R, Fatima J, Siddiqi Z, Kazmi KI and Sultania AR (2010). Original Article Clinical profile of dengue infection at a teaching hospital in North India, (October), 2010–13. - PubMed
    1. Gulati S, Maheshwari A. Atypical manifestations of dengue. Tropical medicine & international health: TM & IH. 2007;12(9):1087–95. - PubMed

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