A clinical study of early manifestations of dengue fever and outcome in children

Abstract

Background: In the past few decades the incidence, distribution, and clinical severity of Dengue have increased dramatically. Population growth in the tropics provides many susceptible hosts. Uncontrolled urbanization leads to inadequate management of water and waste, providing a range of large water stores and disposable, non-biodegradable containers that become habitats for the larvae. Children are now being increasingly affected by this disease. We in this present study tried to study clinical, hematological, and hepatic dysfunction in the early course of the disease. Methods: The present prospective observational study was conducted at Prathima Institute of Medical Sciences, Nagnur, Karimnagar. N=75 children between the age group of 6 months to 15 yrs presenting with symptoms and signs suggestive of dengue fever as per WHO criteria were included in the study. Complete history and clinical examination were done. Investigations were performed as per the proforma. Results: From n=75 children n=56 (75%) belongs to dengue with warning signs and severe dengue whereas n=19 cases (25%) belong to mild dengue group. the symptoms recorded out of n=75 (100%) children presented with fever as the predominant complaint followed by vomiting (49%), Retroorbital pain (28%), Abdominal pain (26%), Edema (25%), Bleeding (19%) and rashes (12%), body ache (8%). The range of platelet count at admission was 4,000 – 98,000/cmm, with a mean value of 53,000 (P>0.05). The WHO criteria of a low platelet count of < 100,000/cmm were seen in all cases (100%). Conclusion: in children, importance should be given to symptoms like fever, vomiting, bleeding, musculoskeletal pain, flushing, and abdominal pain. If these are associated with hepatomegaly, positive tourniquet test, low platelet count, and elevated liver enzymes, a strong possibility of dengue to be considered, especially during an epidemic. During the epidemic, dengue should be considered on the differential diagnosis of any child presenting with fever