Abstract
Background: Around the world dengue incidence has dramatically grown with a large number of asymptomatic cases. Worldwide about 390 million dengue infections were occurring per year, among them 96 million people were developing clinical manifestations with varied severity. About 3.9 billion people residing in 128 countries, were at-risk of dengue virus infection. Dengue fever (DF) is one of the common causes of acute febrile illness. In half the patients with dengue fever skin involvement occurs. Aim & Objectives: To study the socio-demographic parameters, clinical features and laboratory parameters among the patients with and without skin rash in dengue infection. Also determine outcome among the patients with dengue fever and its association with skin rash. Subjects and Methods: A hospital-based, analytical prospective study was conducted in the Department of General Medicine, Sapthagiri Institute of Medical Sciences and Research Center, Bangalore. Patients older than 16 years of age with clinical features and laboratory reports suggestive of dengue infection were included. The study was conducted for a period of 12 months from 1st December 2014 to 30th November 2015. These patients were further divided based on the skin rash presence and absence. The data obtained was entered in Microsoft Excel and analyzed in SPSS version-22 trial. Analysis was done using unpaired students t-test, ANOVA. Results: In total 97 patients with dengue fever were enrolled into the study. About 14.4 p.c (14) patients were with skin rash. The patients with skin rash were found to have lower platelet levels during the disease course. Patients with skin rash had higher percentage of platelet transfusion which was statistically significant. Conclusion: A cutaneous involvement may facilitate clinical diagnosis but it may not be present among all the patients.
Highlights
WHO has simplified the differential diagnosis of Dengue fever (DF) and dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS) based on the presence or absence of major organ involvement. [3,8] Skin involvement occur commonly in DF
About 97 patients with dengue fever were included in the present study
Patients with the presence of skin rash were 14 (14.4%) and 83 (85.6%) patients were without skin rash [Figure1]
Summary
Dengue a mosquito-borne, arboviral disease caused by a single-stranded positive-sense RNA virus belonging to Flaviviridae family with 4 distinct serotypes (DENV-1, DENV2, DENV-3 and DENV-4). [1,2] It is transmitted by female Aedes mosquito mainly belonging to the species A.aegypti and A.albopictus. [3] Infection with any one dengue serotype provides lifelong immunity to that serotype virus, but there is no cross-protective immunity to the other serotypes. [4] Dengue virus infection among humans causes a spectrum of illnesses ranging from inapparent or mild febrile illness to dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). [5] Classic dengue fever characterized by sudden onset of fever (saddle-back), weakness, frontal headache, nausea and vomiting, anorexic, altered taste sensation, a mild sore throat, retroorbital pain, body aches, joint pains, bradycardia, petechiae, facial flushing and rash (scarlatiniform to maculopapular). [6,7]WHO has simplified the differential diagnosis of DF and DHF/DSS based on the presence or absence of major organ involvement. [3,8] Skin involvement occur commonly in DF. [9] During recent years the incidence of dengue around the world has dramatically grown with a large number of asymptomatic cases so the dengue cases which are actual present could not be reported and mostly misclassified. [1] An estimate has indicated 390 million dengue infections per year of which 96 million were developing clinical manifestations with varied severity. [10] Another study reported that about 3.9 billion people, in 128 countries, were at risk of infection with dengue viruses. [11]. [4] Dengue virus infection among humans causes a spectrum of illnesses ranging from inapparent or mild febrile illness to dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Worldwide about 390 million dengue infections were occurring per year, among them 96 million people were developing clinical manifestations with varied severity. In half the patients with dengue fever skin involvement occurs. The aim of the study is to study the socio-demographic parameters, clinical features and laboratory parameters among the patients with and without skin rash in dengue infection. Patients older than 16 years of age with clinical features and laboratory reports suggestive of dengue infection were included. The study was conducted for a period of 12 months from 1st December 2014 to 30th November 2015 These patients were further divided based on the skin rash presence and absence. Conclusion: A cutaneous involvement may facilitate clinical diagnosis but it may not be present among all the patients
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