International Journal of Current Microbiology and Applied Sciences
ISSN: 2319-7706 Volume 2 Number 10 (2013) pp. 338-346
Clinico-haematological profile and outcome of dengue fever in children
C.V.Prathyusha1 *, M.Srinivasa Rao2 , P.Sudarsini3 and K.Uma maheswara Rao4
1PG in Pediatrics, Department of Pediatrics, Alluri Sitarama Raju Academy of Medical sciences, Eluru, 534004,West Godavari District, A.P State, India 2 Associate professor, Department of Pediatrics, Alluri Sitarama Raju Academy of Medical sciences, Eluru - 534004,West Godavari District, A.P State, India 3Professor and HOD, Department of Pediatrics, Alluri Sitarama Raju Academy of Medical sciences, Eluru - 534004,West Godavari District, A.P State, India 4Professor, Department of Pediatrics, Alluri Sitarama Raju Academy of Medical sciences, Eluru, 534004,West Godavari District, A.P State
ABSTRACT
To evaluate clinical features, disease severity, laboratory findings and outcome of serologically confirmed cases of dengue fever in children between May 2012 to October 2012. Dengue fever cases admitted in the Pediatric department of Alluri Sita Ramaraju Academy of Medical Sciences, Eluru. Eighty children with Dengue fever were hospitalized in the Pediatric department of ASRAM. Each case was evaluated and followed for various clinical manifestations and outcome. All the children were monitored and managed according to standardized WHO protocol. The mean age of patients is 9.77+4.1 with almost equal male to female ratio. Among 80 patients 32.5% had dengue fever, 3.75% had DHF1, 36.25% had DHFII, 21.2% had DHFIII and 6.25% had DHF IV. The common symptoms were fever (100%), abdominal pain(58%), vomiting(42%), myalgias(32%), itchy rash(28%). Bleeding manifestations were seen in 68.7% cases with petechiae (70%) being the most common followed by melena(23%), hematemesis (20%), epistaxis(7%), gum bleeds(6%), Haematuria (6%) and menorrhagia (3%). Hepatomegaly is seen in 33.75% cases, leak syndrome in 25% cases. Thrombocytopenia in 85% cases, among which 78% had haemorrhagic manifestations. Mean platelet count in DHF cases is 40758+ 27180.Torniquet is positive in 38.7% of cases, The sensitivity of the tourniquet test for haemorrhagic manifestations is 56% and Specificity is 88%. 72% of cases of patients with thrombocytopenia had leucopenia (p value 0.009). The complications seen were liver dysfunction(17.5%), coagulopathy (7.5%), encephalopathy(2.5%) pancreatitis (1.25%) and ARDS (1.25%).Mortality in the study is 6.25% with DSS with coagulopathy(5%) being the lead cause followed by DSS with ARDS (1.25%). The common symptoms were fever, abdominal pain, vomiting, petechiae, GI bleeds. The incidence of bleeding is higher with increasing severity of thrombocytopenia. Tourniquet test is not a good screening test for haemorrhagic manifestations. Leucopenia is also a significant feature in patients with thrombocytopenia . Refractory shock and coagulopathy were main causes of mortality
Keywords
To evaluate clinical features, disease severity, laboratory findings and outcome of serologically confirmed cases of dengue fever in children between May 2012 to October 2012. Dengue fever cases admitted in the Pediatric department of Alluri Sita Ramaraju Academy of Medical Sciences, Eluru. Eighty children with Dengue fever were hospitalized in the Pediatric department of ASRAM. Each case was evaluated and followed for various clinical manifestations and outcome. All the children were monitored and managed according to standardized WHO protocol. The mean age of patients is 9.77+4.1 with almost equal male to female ratio. Among 80 patients 32.5% had dengue fever, 3.75% had DHF1, 36.25% had DHFII, 21.2% had DHFIII and 6.25% had DHF IV. The common symptoms were fever (100%), abdominal pain(58%), vomiting(42%), myalgias(32%), itchy rash(28%). Bleeding manifestations were seen in 68.7% cases with petechiae (70%) being the most common followed by melena(23%), hematemesis (20%), epistaxis(7%), gum bleeds(6%), Haematuria (6%) and menorrhagia (3%). Hepatomegaly is seen in 33.75% cases, leak syndrome in 25% cases. Thrombocytopenia in 85% cases, among which 78% had haemorrhagic manifestations. Mean platelet count in DHF cases is 40758+ 27180.Torniquet is positive in 38.7% of cases, The sensitivity of the tourniquet test for haemorrhagic manifestations is 56% and Specificity is 88%. 72% of cases of patients with thrombocytopenia had leucopenia (p value 0.009). The complications seen were liver dysfunction(17.5%), coagulopathy (7.5%), encephalopathy(2.5%) pancreatitis (1.25%) and ARDS (1.25%).Mortality in the study is 6.25% with DSS with coagulopathy(5%) being the lead cause followed by DSS with ARDS (1.25%). The common symptoms were fever, abdominal pain, vomiting, petechiae, GI bleeds. The incidence of bleeding is higher with increasing severity of thrombocytopenia. Tourniquet test is not a good screening test for haemorrhagic manifestations. Leucopenia is also a significant feature in patients with thrombocytopenia . Refractory shock and coagulopathy were main causes of mortality