DENGUE HEMORRHAGIC FEVER IN THE STATE OF CEARÁ, BRAZIL, 2005

Abstract

Dengue is the most common cause of arboviral disease in the world. The aim of this study was to evaluate the clinical manifestations, laboratory features and outcome of dengue hemorrhagic fever. This is a retrospective study including 49 consecutive patients with dengue hemorrhagic fever in Fortaleza, Brazil, between February and August 2005. Statistical analysis was performed through the software SPSS 10.0 for windows. Patients’ mean age was 34.8±16.8 years; 59.2% were female. The main clinical signs and symptoms at admission were: fever (95.9%), headache (91.8%), myalgia (87.8%), abdominal pain (77.5%) and asthenia (73.5%). Hemorrhagic manifestations were present in 29 (59.2%) patients, including petechia (32.7%), gingival bleeding (18.4%), epistaxis (12.2%), echimosis (12.2%) and melena (12.2%). The tourniquet test was positive in 3 of 11 patients (27.2%). Platelets count at admission was 82,644±53,147/mm³. All patients presented platelets < 100,000/mm 3 . There was significant difference between admission and hospital discharge platelets count (82,644±53,147 vs. 146,081±88,999/mm³, p < 0.001). There was significant decrease between admission and hospital discharge haemoglobin and hematocrit (13.5±1.9 vs. 12.7±1.5/mm³, P = 0.002 and 41.0±5.9% vs. 38.6±4.8%, p = 0.001, respectively). All patients received venous hydration with saline solution. The mean infusion used was 2,513±1,065 mL daily. Four patients (8.1%) received blood transfusions and 9 (18.3%) platelets transfusions. Two patients died (4.1%) due to hypovolemic shock. Dengue is an endemic disease in emergent countries, with potential fatal outcome. Signs and symptoms suggestive of dengue hemorrhagic fever must be known by any physician in order to institute early adequate treatment. DOI: http://dx.doi.org/10.17525/vrrjournal.v15i1.37