Clinico-pathological profile in the infants and children in dengue 2012 epidemic, Kolkata

Abstract

Background: Dengue fever (DF) is responsible for cyclical and frequent epidemic in different parts of India in its varieties of presentations. In 1992 large number of children died of Dengue hemorrhagic fever (DHF). Aims and objective: In this study, we evaluated the demography and clinico-pathological profile in dengue affected infants and children in 2012 Kolkata epidemic. Materials and methods: Total 233 patients (between 1-18 years, with either Non structural protein 1 antigen or dengue Immunoglobulin positive) admitted in our hospital. After taking proper history and physical examination, blood were sent for different hematological and biochemical examinations on the day of admission and after 24-48 hours of admission. We differentiated the dengue patients into DF and DHF based on platelet count. Results: Male female ratio and DF to DHF ratio were 1: 0.86 and 1: 3.5 respectively. Mean age of DF and DHF were 10.31±5.41 years and 12.6±4.51 years respectively. Mean duration of fever in DF and DHF cases were 5.33±1.13 and 6.08±1.79 days respectively. Headache, backache, nausea/vomiting, rash, anorexia, loose motions were statistically significant in DF. In spite of significant positive tourniquet test in DHF patients (76.92%), only 13 patients showed evidence of bleeding. Hematocrit (Hct) values between 30-40 and below 30 were significant in DHF and DF patients respectively. Leucopenia and increased liver enzymes (SGOT and SGPT) were commonly observed in both DF and DHF patients. Hepatomegaly was observed in 13.72% of DF patients, whereas, isolated hepatomegaly, ascites, combined hepatomegaly with ascites and evidence of pleural effusion were observed in 4.94%, 1.64%, 3.29% and 7.14% of DHF patients respectively. Conclusion: In seropositive DHF patients, fever, headache, backache, loose motions were the predominant symptoms associated with hepatomegaly, elevated liver enzymes and evidence of plasma leakage.