Details
Category: Volume 06 Issue 07 July 2018
Hits: 1250

Title: A study of clinical manifestations, laboratory profile and outcome of dengue fever in a tertiary care centre in South Karnataka

Authors: Shashikantha, Srikanth Goud Mallam, Yash Khanvilkar, Manojkumar B K

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i7.99

Abstract

Background: Dengue is an important cause of mortality and morbidity in India. Many recent studies have shown varied clinical manifestations from different geographical locations. There is inadequacy of data on this topic from this region. The present study was conducted to find out the clinical features, complications, and outcome of patients suffering from dengue in a tertiary care centre of South Karnataka, India.

Methods: The study was performed at Adichunchanagiri Institute of Medical Sciences, B. G. Nagara, which is a tertiary care hospital of Karnataka. The study period was of 6 months from June 2017 to December 2017. Patients of 18 years of age or above it who were antigen positive or antibody positive were included in the study. All such patients admitted in the hospital underwent distinct medical examination and investigation. 

Results: Dengue infection was identified in 60 patients. Thrombocytopenia was the commonest hematological abnormality. Splenomegaly, hepatomegaly, and hepatosplenomegaly, were common findings. Renal, hepatic and cerebral dysfunctions were noted. Mortality was seen in 2 (3.3%) patients. Encephalitis, shock and ARDS were associated with high mortality and poor outcome.

Conclusions: Dengue is an important cause of mortality and morbidity in Karnataka. High index of suspicion, early diagnosis, monitoring of the clinical and laboratory parameters and prompt intervention may help in reducing the mortality.

Keywords: Dengue, Clinical manifestations, Laboratory profile, Karnataka.

References

  1. World Health Organization. Dengue and Severe Dengue. Fact sheets, 2014. Available at: http://www.who.int/mediacentre/factsheets/fs117/en /. Accessed 19 December 2014.
  2. World Health Organization. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control, 2015. Available at: whqlibdoc.who.int/publications/2015/97892415478 71_eng.pdf.
  3. World Health Organization. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control, 2nd ed. Geneva, Switzerland: WHO; 1997: 1-83.
  4. Deen JL, Harris E, Wills B, Balmaseda A. Hammond SN, Rocha C, et al. The WHO dengue Classification and case definitions: time for a reassessment. Lancet. 2006;368:170-3.
  5. Rajadhyaksha A, Mehra S. Dengue fever evolving into systemic lupus erythematosus and lupus nephritis: a case report. Lupus. 2012;21:999-1002.
  6. Kanungo S, Shukla D, Kim R. Branch retinal artery occlusion secondary to dengue fever. Indian J Ophthalmol. 2008;56:73-4.
  7. Matlani M, Chakravarti A. Changing trends of dengue disease: a brief report from a tertiary care hospital in New Delhi. Braz J Infect Dis. 2011;15:184-5.
  8. Karoli R, Fatima J, Siddiqi Z, Khursheed, KazmiKI, Sultania AR. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Dev Ctries 2012;6(7):551-4.
  9. Rachel D, Rajamohanan, Philip AZ. A Study of Clinical Profile of Dengue Fever in Kollam, Kerala, India.Dengue Bulletin. 2005;29:197-202.
  10. Vinod HR, Shepur TA, Wari PK, Chavan SC, Mujahid IB, Yergolkar PN. Clinical Profile and Outcome of Dengue Fever Cases. Indian J Pediatr 2005;72(8):705-6.
  11. Bandyopadhyay B, Bhattacharyya I, Adhikary S et al. “A Comprehensive Study on the 2012 Dengue Fever Outbreak in Kolkata, India,” ISRN Virology. 2013;2013:5.
  12. Shukla V, Chandra A. A study of hepatic dysfunction in dengue. J Assoc physican India. 2013;61.
  13. Soundravally R, Sankar P, Bobby Z, Hoti SL. Oxidative stress in severe dengue viral infection: association of thrombocytopenia with lipid peroxidation. Platelets. 2008;19:447-54.
  14. Thomas EA, John M, Bhatia A. Cutaneous manifestations of dengue viral infection in Punjab (north India) Int J Dermatol. 2007;46:715-9.
  15. Thomas EA, John M, Kanish B. Mucocutaneous manifestations of dengue fever. Indian J Dermatol. 2010;55:79-85.
  16. Motla M, Manaktala S, Gupta V, Aggarwal M, Bhoi SK, Aggarwal P et al. Sonographic evidence of ascites, pleura-pericardial effusion and gallbladder wall edema for dengue fever. Prehosp Disaster Med. 2011;26:335-41.
  17. Parkash O, Almas A, Jafri Wasmin SM, Hamid S, Akhtar J, Alishah H. Severity of acute hepatitis and its outcome in patients with dengue fever in a tertiary care hospital Karachi, Pakistan (South Asia). BMC Gastroenterology 2010;10:43.
  18. Itha S, Kashyap R Krishnani N, Saraswat VA, Choudhri G, Aggarwal R. Profile of liver involvement in dengue viral infection. Natl Med J   2005 May-Jun;18(3):127-30.
  19. de Souza LJ, Goncalves Carneiro H, Souto Filho JT, Ferreira de Souza T, Azevedo Cortes V, Neto CG, Bastos Assed D, Wallace da Silva Siqueira E. Hepatitis in dengue shock syndrome. Braz J Infect Dis 2002;6:322-7.
  20. Wiwanitkit V. Acute renal failure in the fatal cases of dengue hemorrhagic fever, asummary in Thai death cases. Ren Fail. 2005;27:647.
  21. Laoprasopwattana K, Pruekprasert P, Dissaneewate P, Geater A, Vachvanichsanong P. Outcome of dengue hemorrhagic fever-caused acute kidney injury in Thai children. J Pediatr 2010;157:303-9.
  22. Lee IK, Liu JW, Yang KD. Clinical characteristics, risk factors, and outcomes in adults experiencing dengue hemorrhagic fever complicated with acute renal failure. Am J Trop Med Hyg 2009;80:651-5.
  23. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control WHO, 2009. Available at: http://whqlibdoc.who.int/publications/2009/978924 1547871eng.pdf. Accessed 5 July 2012.
  24. Deepak NA, Patel ND. Differential diagnosis of acute liver failure in India. Ann Hepatol. 2006;5:150-6.
  25. Vinodh BN, Bammigatti C, Kumar A, Mittal V. Dengue fever with acute liver failure. J Postgrad Med. 2005;51:322-3.
  26. Jhamb R, Kashyap B, Ranga GS, Kumar A. Dengue fever presenting as acute liver failure - a case report. Asian Pac J Trop Med. 2011;4:323-4.

Corresponding Author

Srikanth Goud Mallam

2rd year Junior Resident, Department of  Medicine, Adichunchanagiri Institute of Medical Sciences Balagangadharanatha Nagara,  Nagamangala, mandya-571448, Karnataka, India