Abstract
Dengue viral infections are among the most important mosquito-borne diseases of the Indian subcontinent and have become a major global public health concern. Spread of disease has led to increased recognition of atypical manifestations apart from the classical clinical features of dengue infection. A cross-sectional study of admitted patients suspected to have dengue infection was conducted during the monsoon and post-monsoon seasons in the year 2010. Patients who had serological confirmation of dengue infection were classified according to World Health Organization definitions of dengue fever and dengue hemorrhagic fever. Clinical and biochemical parameters were compared between the two groups. Out of 356 patients with suspected dengue fever enrolled in the study, 138 (39%) had serologically confirmed dengue infection. Eighty (58%) patients were males and 58 (42%) were females. Ninety-six (70%) patients had classical dengue fever while 42 (30%) had dengue hemorrhagic fever. The most common symptoms were headache (105, 76%), abdominal pain (87, 63%), vomiting (80, 58%), rash (36, 26%), and cutaneous hypersensitivity (22, 16%). Hemorrhagic manifestations were present in 55 (40%) patients. Atypical manifestations were recorded. Notably, 14% of patients had neurological involvement and 4% had acute hepatic failure. Overall mortality was 6% and all fatal cases were due to multi-organ failure. Dengue infection poses a huge burden to the health-care system; its spectrum ranges from mild self-limiting illness to severe fatal disease. It can have varied and multi-systemic manifestations which can go unrecognized. Clinicians should have a high index of suspicion for atypical manifestations.
Highlights
Dengue viral infections are among the most important mosquito-borne diseases of the Indian subcontinent and have become a major global public health concern
Dengue infections vary in severity, ranging from influenza-like self-limiting illness to life-threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) which, if left untreated, are associated with mortality as high as 20% [2]
We undertook this prospective study in the Department of Medicine, Era’s Lucknow Medical College, from July to October 2010 to assess the clinical profile of dengue infection in hospitalized patients as well as to observe rare manifestations of dengue fever in the current outbreak and compare them with the World Health Organization (WHO) dengue classification [11]
Summary
Dengue has become a major global public health concern. Approximately 2.5 billion people, living mainly in urban areas of tropical and subtropical regions, are estimated to be at risk of acquiring dengue infection [1]. Some presentations that are not classifiable under the World Health Organization (WHO) definitions may be potentially serious and may lead to increased morbidity and mortality of the disease Many of these manifestations may remain unrecognized and unreported due to lack of awareness among primary care physicians. The most recent dengue outbreak was observed in the northern part of the country last year during the monsoon and post-monsoon period. We undertook this prospective study in the Department of Medicine, Era’s Lucknow Medical College, from July to October 2010 to assess the clinical profile of dengue infection in hospitalized patients as well as to observe rare manifestations of dengue fever in the current outbreak and compare them with the WHO dengue classification [11]. USA) with p < 0.05 taken as statistically significant
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