Clinically profiling pediatric patients with dengue

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 cas...

Full description

Bibliographic Details
Main Authors: Sriram Pothapregada, Banupriya Kamalakannan, Mahalaskhmy Thulasingham, Srinivasan Sampath
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Journal of Global Infectious Diseases
Subjects:
Online Access:http://www.jgid.org/article.asp?issn=0974-777X;year=2016;volume=8;issue=3;spage=115;epage=120;aulast=Pothapregada
_version_ 1818540873539911680
author Sriram Pothapregada
Banupriya Kamalakannan
Mahalaskhmy Thulasingham
Srinivasan Sampath
author_facet Sriram Pothapregada
Banupriya Kamalakannan
Mahalaskhmy Thulasingham
Srinivasan Sampath
author_sort Sriram Pothapregada
collection DOAJ
description 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.
first_indexed 2024-12-11T22:01:07Z
format Article
id doaj.art-cf9453115f114f88a6f74d56d52e84c8
institution Directory Open Access Journal
issn 0974-777X
language English
last_indexed 2024-12-11T22:01:07Z
publishDate 2016-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Journal of Global Infectious Diseases
spelling doaj.art-cf9453115f114f88a6f74d56d52e84c82022-12-22T00:49:07ZengWolters Kluwer Medknow PublicationsJournal of Global Infectious Diseases0974-777X2016-01-018311512010.4103/0974-777X.188596Clinically profiling pediatric patients with dengueSriram PothapregadaBanupriya KamalakannanMahalaskhmy ThulasinghamSrinivasan SampathObjective: 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.http://www.jgid.org/article.asp?issn=0974-777X;year=2016;volume=8;issue=3;spage=115;epage=120;aulast=PothapregadaBleedingdengue fevermultiorgan failureshock
spellingShingle Sriram Pothapregada
Banupriya Kamalakannan
Mahalaskhmy Thulasingham
Srinivasan Sampath
Clinically profiling pediatric patients with dengue
Journal of Global Infectious Diseases
Bleeding
dengue fever
multiorgan failure
shock
title Clinically profiling pediatric patients with dengue
title_full Clinically profiling pediatric patients with dengue
title_fullStr Clinically profiling pediatric patients with dengue
title_full_unstemmed Clinically profiling pediatric patients with dengue
title_short Clinically profiling pediatric patients with dengue
title_sort clinically profiling pediatric patients with dengue
topic Bleeding
dengue fever
multiorgan failure
shock
url http://www.jgid.org/article.asp?issn=0974-777X;year=2016;volume=8;issue=3;spage=115;epage=120;aulast=Pothapregada
work_keys_str_mv AT srirampothapregada clinicallyprofilingpediatricpatientswithdengue
AT banupriyakamalakannan clinicallyprofilingpediatricpatientswithdengue
AT mahalaskhmythulasingham clinicallyprofilingpediatricpatientswithdengue
AT srinivasansampath clinicallyprofilingpediatricpatientswithdengue