Title: Clinical spectrum of fever cases in correlation with hemato-biochemical and radiological parameters- an Experience from a Zonal Hospital in Eastern India
Authors: Lt Col Santosh Kumar Singh, Col Sarvinder Singh, Lt Col TentuAjai Kumar, Col Ajay Kumar Singh, Lt Col Barun Kumar Chakrabarty, Dr Vani Singh, Maj Rachana Warrier, Capt Nidhi Singh, Lt Chinmaya Dash, Maj Sunny Pathania
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.135
Abstract
Introduction: The purpose of this study is to study the clinical spectrum of fever cases, outline the hematobiochemical and serological parameters and delineate a syndromic approach to tropical infections in a zonal hospital of eastern India.
Methods: The study included 120 cases of fever admitted to our hospital in ICU and acute medical wards and corelating their clinical manifestations with the lab parameters (hematological, biochemical, serology) and imaging modalities.
Results: Out of 120 cases admitted with fever, 39(32.33%) cases were undifferentiated viral fever, 15(12.5%) were enteric fever, 13(10.8%) were dengue, 8(6.7%) were malaria, 3(2.5%) each of hepatitis A and hepatitis E, 8(6.7%) of varicella, 6(5%) of pneumonia and 5(4.2%) of UTI. 5 cases each of meningoencephalitis and liver abscess were reported along with 2 cases each of scrub typhus, leptospirosis, chikungunya, kala azar and viral interstitial pneumonia.
Conclusion: Our study has focused on the bedside clues which help the physician in solving the diagnostic conundrum of tropical diseases that are encountered commonly in our country and their correlations with hemato-biochemical, serological and diagnostic imaging modalities which will guide us the therapeutic modalities.
Keywords: Tropical infections, dengue fever, mixed infections, enteric fever, meningoencephalitis, leptospirosis.
References
- Blumberg L, Ogunbanjo GA, Durrheim DN. Fever in adults-approach to diagnosis and management, SA Fam Pract .2000;22:23-26.
- Joshi R, Colford JM, Reingold A. Nonmalarial acute undifferentiated fever in a rural hospital in central India – Diagnostic uncertainty and overtreatment with anti-malarial agents. Am J Trop Med Hyg. 2008;78(3):393-99.
- Chrispal A, Boorugu H, Gopinath KG, Chandy S, Prakash JA,et al. Acute undifferentiated febrile illness in India. Int Journal of Emer Med. 2011;4:57.
- Chrispal A, Boorugu H, Gopinath KG, Chandy S, Prakash JA,et al. Acute undifferentiated febrile illness in adult hospitalized patients: the disease spectrum and diagnostic predictors – an experience from a tertiary care hospital in South India. Trop Doc. 2010;40(4):230-34.
- Garima Mittal, Sohaib Ahmad, R K Agarwal, Minakshi Dhar, Manish Mittal,et al . Aetiologies of Acute Undifferentiated Febrile illness in Adult Patients – an Experience from a Tertiary Care Hospital in Northern India Journal of Clinical and Diagnostic Research. 2015 Dec, Vol-9(12): DC22-4.
- Singh R, Singh SP, Ahmad N. A Study of Etiological Pattern in an Epidemic of Acute Febrile Illness during Monsoon in a Tertiary Health Care Institute of Uttarakhand, India. J Clin Diagn Res. 2014;8(6):MC01-03.
- Sharma A, Raina R, Dhiman P, Adarsh, Madhabhavi I, Panda P. Rare Coinfection of Scrub Typhus and Malaria in Immunocompetent Person. Online J Health Allied Scs. 2012;11(2):12.
- Shashidharan VK, Nagpal AK. Tropical infections in ICU. In: Handbook of Medical Emergencies, 2nd Edition, India: Department of Internal Medicine, AFMC Pune; 2015. 306-19.
- Bhutta ZA, Current concepts in the diagnosis and treatment of typhoid fever. BMJ.2006;333(7558):78-82.
- Shiv L, Joshi PL, Nilima K, Sanjib M, Kocher DK, et al. Guidelines for diagnosis and treatment of malaria in India 2014,3rd edition. National Institute of Malaria Research, New Delhi, India;2014.1-13.