Pediatric Infectious Disease

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VOLUME 2 , ISSUE 1 ( January-March, 2020 ) > List of Articles

ORIGINAL RESEARCH

Clinical, Epidemiological, Biochemical Profile and Outcomes of Dengue and Dengue-like Illness in Children

Himani Dhingra, Bhushan Kathuria, Chandrahas T Deshmukh

Citation Information : Dhingra H, Kathuria B, Deshmukh CT. Clinical, Epidemiological, Biochemical Profile and Outcomes of Dengue and Dengue-like Illness in Children. Pediatr Inf Dis 2020; 2 (1):1-5.

DOI: 10.5005/jp-journals-10081-1235

License: CC BY-NC 4.0

Published Online: 14-08-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Dengue viral infection presents with a highly complex pathophysiological, economic, and ecologic problems. Through this study we aim to analyze the changing epidemiology and seasonal clustering of dengue fever cases. Also, we aim to analyze the clinical presentation, biochemical parameters, treatment given, and determine whether they have any association with the disease severity and outcome. Materials and methods: The present cross-sectional, observational study was conducted over a period of 1½ years including a total 255 patients of probable dengue, confirmed dengue, and dengue-like illness (DLI). Statistical association of various qualitative and quantitative parameters of the disease was made with both disease severity and disease outcome. Results: There were 27.8% patients in the age group 10–12 years and 11% infants in our study. Maximum patients were admitted in the post-monsoon months. Fever was the most common symptom and abdominal tenderness was the most common sign. Leucopenia was the most frequent hematological abnormality noted in our study. Mean day of appearance of hematological derangements corroborated with the onset of critical phase of dengue. The NS1 antigen test was found to be most useful for diagnosis with maximum percentage positivity, rapid results, ease of availability, and cost-effectiveness. Mean day of illness for NS1 positivity was 4.6 ± 2.9 days. Ultrasound abdomen was a sensitive test to predict early signs of plasma leakage. Substantial number of patients could be managed with oral fluids only; however, a few required an intravenous (iv) crystalloid bolus at the time of presentation. Blood products were sparingly used in our study. Antibiotic use did not alter disease course and outcome, hence is not recommended. Very few patients needed intensive care unit (ICU) admission. There were 13 deaths (mortality rate of 5.1%) during the study period. The rate of development of complications and also mortality was quite considerable in the DLI group. Hence, from the present study we emphasize that the DLI group should not be alienated from the continuum of spectrum of dengue viral infections. Conclusion: Presence of bleeding, encephalopathy, clinical/radiological signs of plasma leakage, hypotension, hepatomegaly, coagulopathy, deranged liver function test (LFT), and hemoconcentration with thrombocytopenia are indicative of a severe dengue disease and can also be used as surrogate markers for poor prognosis.


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