Clinical Brief

Clinical Profile and Outcome of Dengue Fever Cases

V i n o d H. Ratageri, T.A. S h e p u r , P.K. Wari, S.C. C h a v a n , I.B. M u j a h i d I a n d P.N. Yergolkar 2

Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubli, ~PICU, Hubli Children Hospital, Hubli
2National Institute of Virology, Field Station, Bangalore, Karnataka, India.

Abstract. Dengue fever is on rise globally. In India, Dengue epidemics are expanding geographically, even into the rural areas.
Dengue can present with varied manifestations. The mortality rate has been brought down with high index of suspicion, strict
monitoring and proper fluid resuscitation. Herewith, we are presenting clinical features and outcome of Dengue cases seen
in and around Hubli (North Karnataka). [Indian J Pediatr 2005; 72 (8) : 705-706] E-maih ratageri@rediffmail.com

Key words : Dengue fever; Clinical features; Out come.

Over the past two decades there has been dramatic global Abbreviations
increase in Denguefever, (DF) Dengue haemorrhagic fever,
and Dengue shock syndrome and their epidemics. 1,2 The DF = Dengue fever
number of cases in SE-Asia increased in the last 3-5 years. 3 DHF = Dengue haemorrhagic fever
In India, there is increased proportion of Dengue cases DSS = Dengue shock syndrome
with severe disease. The dengue epidemics in India are MAC = IgM antibody capture
cyclical and are more frequent, expanding geographically HCT = Haematocrit
into the r u r a l areas a n d all f o r m s of s e r o t y p e s are DEN2 = Dengue serotype 2
circulating in the c o m m u n i t y . 4 The identification of URI = Upper respiration tract infection
dengue cases is by distinct clinical features but they can
present with varied manifestations. 5 Dengue remains a and h e p a t o m e g a l y (87%). The c o m m o n b l e e d i n g
puzzling disease in many aspects, such as the virus-vector manifestations were G I bleeding (22%) and petechiae
and h o s t - v i r u s relationship, and clinical e x p r e s s i o n (18%). Table 1 shows the unusual presentation in the
variability. The present study was undertaken to evaluate p r e s e n t series. The m e a n d u r a t i o n of f e v e r p r i o r to
the clinical f e a t u r e s and o u t c o m e of s e r o l o g i c a l l y admission was 5.47 days (2-12 days). P a l m o - P l a n t e r
confirmed dengue cases at Hubli (N. Karnataka). exfoliation in three cases during defervescence period was
A r e t r o s p e c t i v e r e v i e w of hospital case p a p e r s of noticed.
dengue patients, who were admitted to pediatric ward,
K.I.M.S-Hubli and PICU, Hubli children hospital, Hubli TABLE1. Unusual Clinical Features (n=23)
between July 2003 to June 2004 (one year) was carried out.
Clinical features Number (%)
Only confirmed Dengue cases by serological study from
N a t i o n a l Institute of Virology, ICMR, Field station, Upper Respiration tract infection (URI) 15 (65%)
Bangalore were included. Serological study was carried Encephalitis 05 (22%)
out using MAC ELISA technique for different serotypes. Diarrhea 03 (13%)
Jaundice 01 (04%)
Clinical, laboratory and outcome of these children were Lymphadenopathy 01 (04%)
taken for analysis. ExfoliativeDermatitis 03 (13%)
Total number of confirmed dengue cases was 23 and (Palma-Planter)
all of them were positive to serotype 2 viruses (DEN2).
Eight (35%) of these were infants. There was no difference
in male to female ratio (11:12) although severity was more Among the laboratory investigations, the haematocrit,
noticed in females. By WHO Classification, dengue fever platelet counts and l e u k o c y t e c o u n t was sent for all
was present in04 (18%) cases, DHF in 14(60%) and DSS in children. Leucopenia (<5000/cumin) was present in 06
05(22%) cases. The c o m m o n clinical features noted in (26%), thrombocytopenia ( < l l a k h / c u m m ) in 19 (82%)
order of frequency were fever (100%), vomiting(82%), and mean Hct value for Dengue fever, DHF and DSS
pain abdomen (61%), restlessness(65%), headache (22%), were 31.5%, 30.75% and 30.4% respectively at the time of
admission. Among the imaging studies, chest-X-ray was
Correspondence and Reprint requests : Dr. Vinod H. Ratageri, Asst. taken for all children. Pleural effusion was present in 16
Professor, Department of Pediatrics, Karnataka Institute of Medical (70%) cases and more so, on right side 12 (52%). USG
Sciences, Hubli-580021. Karnataka.

Indian Journal of Pediatrics, Volume 72--August, 2005 705