Comparison of the clinical manifestations exhibited by dengue and nondengue patients among children in a medical center in southern Taiwan

Abstract

Dengue is one of the most important mosquito-borne diseases. Taiwan is located in an epidemic area for dengue, and several dengue outbreaks have been reported in southern Taiwan. Therefore, we conducted this study to determine the incidence and clinical manifestations of symptomatic dengue infection. We reviewed the medical records of 177 pediatric patients (age < 16 years) who underwent serum tests for dengue (polymerase chain reaction or capture enzyme-linked immunosorbent assay for dengue immunoglobulin M and immunoglobulin G antibodies) in the pediatric outpatient clinic, the pediatric ward, or the emergency department of the Chi-Mei Medical Center from January 1, 2007 to December 31, 2007. We evaluated the differences in the clinical characteristics and laboratory data between the dengue and nondengue patients. Most of the dengue cases appeared starting in July and peaked during November. In the dengue group, there were more school-age patients (age > 7 years) and a more frequent history of mosquito contact. There was no difference in the sex distribution. Most of the dengue patients had obvious symptoms including skin rash (79.0%), nausea/vomiting (47.4%), high fever (> 39°C; 44.7%), diarrhea (26.3%), abdominal pain (23.7%), and petechiae (15.8%). Leukopenia, thrombocytopenia, elevated aspartate aminotransferase levels, and elevated alanine aminotransferase levels were found in 78.4%, 79.3%, 34.5%, and 29.0% of the patients, respectively. Nondengue patients showed elevated C-reactive protein levels (57.5%). Dengue is commonly found in older pediatric patients and is rare in infants. High fever and skin and gastrointestinal manifestations were usually found in dengue patients. The laboratory findings of leukopenia, thrombocytopenia, elevated levels of liver enzymes, and low C-reactive protein levels were common in dengue patients, and these markers could help confirm the suspicion of pediatric dengue infection.