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. 2016 Jul-Sep;8(3):115-20.
doi: 10.4103/0974-777X.188596.

Clinically Profiling Pediatric Patients with Dengue

Sriram Pothapregada  1 , Banupriya Kamalakannan  1 , Mahalaskhmy Thulasingham  2 , Srinivasan Sampath  3
Affiliations

Clinically Profiling Pediatric Patients with Dengue

Sriram Pothapregada et al. J Glob Infect Dis. 2016 Jul-Sep.

Abstract

Objective: To study the clinical profile and outcome of dengue fever in children at a tertiary care hospital in Puducherry.

Materials and methods: All children (0-12 years of age) diagnosed and confirmed as dengue fever from August 2012 to January 2015 were reviewed retrospectively from hospital case records as per the revised World Health Organization guidelines for dengue fever. The diagnosis was confirmed by NS1 antigen-based ELISA test or dengue serology for IgM and IgG antibodies, and the data were analyzed using SPSS 16.0 statistical software. After collecting the data, all the variables were summarized by descriptive statistics.

Results: Among the 261 confirmed cases of dengue fever non-severe and severe dengue infection was seen in 60.9% and 39.1%, respectively. The mean age (standard deviation) of the presentation was 6.9 + 3.3 years and male: female ratio was 1.2:1. The most common clinical manifestations were fever (94.6%), conjunctival congestion (89.6%), myalgia (81.9%), coryza (79.7%), headache (75.1%), palmar erythema (62.8%), and retro-orbital pain (51.3%). The common early warning signs at the time of admission were persistent vomiting (75.1%), liver enlargement (59.8%), cold and clammy extremities (45.2%), pain abdomen (31.0%), hypotension (29.5%), restlessness (26.4%), giddiness (23.0%), bleeding (19.9%), and oliguria (18.4%). The common manifestation of severe dengue infection was shock (39.1%), bleeding (19.9%), and multi-organ dysfunction (2.3%). The most common complications were liver dysfunction, acute respiratory distress syndrome, encephalopathy, pleural effusion, ascites, myocarditis, myositis, acute kidney injury, and disseminated intravascular coagulopathy. Platelet count did not always correlate well with the severity of bleeding. There were six deaths (2.3%) and out of them four presented with impaired consciousness (66.6%). The common causes for poor outcome were multiorgan failure, encephalopathy, and fluid refractory shock.

Conclusion: There has been a resurgence of dengue fever with a change in the pattern of presentation during the recent epidemics. Clinical vigilance and awareness regarding the changing epidemic pattern and timely detection of cases are vital to reduce mortality and morbidity due to severe dengue infection.

Keywords: Bleeding; dengue fever; multiorgan failure; shock.

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Figures

Figure 1
Figure 1
Geographical origin of dengue fever cases admitted at a tertiary care hospital in Puducherry
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 Hemorrhagic Fever, Revised and Expanded Edition. WHO-SEARO 2011. (SEARO Technical Publication Series No. 60) 2011
    1. Faridi MM, Aggarwal A, Kumar M, Sarafrazul A. Clinical and biochemical profile of dengue haemorrhagic fever in children in Delhi. Trop Doct. 2008;38:28–30. - PubMed
    1. Wichmann O, Hongsiriwon S, Bowonwatanuwong C, Chotivanich K, Sukthana Y, Pukrittayakamee S. Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand. Trop Med Int Health. 2004;9:1022–9. - PubMed
    1. Aggarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK. An epidemic of dengue hemorrhagic fever and dengue shock syndrome in children in Delhi. Indian Pediatr. 1998;35:727–32. - PubMed
    1. Gurdeep SD, Deepak B, Harmesh SB. Clinical profile and outcome of children of dengue hemorrhagic fever in North India. Iran J Pediatr. 2008;18:222–8.