English

Abstract

Dengue is the arthropode borne viral infection transmitted by mosquitoes to humans. AIM: To study the various clinical manifestations and acute complications of dengue fever. METHODS: 100 cases of confirmed dengue infection admitted to KIMS, Bangalore between December 2009 and September 2011 were studied. A detailed clinical history and physical examination was done and baseline investigations were performed. The cases were followed-up daily for the clinical and laboratory parameters and were treated according to WHO guidelines. The data related to each of these cases was collected, compiled and analyzed. RESULTS: of the total 100 cases there were 61 male and 39 female. Age group of 21-30 (41) was most commonly affected Maximum number of patients was seen in the September, October, august, July. Commonest presentation was Fever (100%) followed by Headache (78%), Myalgia (70%), Arthralgia (66%), low back ache (60%). On examination patients found to have icterus (22%), bleeding spots (26%), rashes (50%), Splenomegaly (18%), Hepatomegaly (15%) and Ascites (9%), pleural effusion (16%), crepitations (7%). Platelet count was not very well correlated with the bleeding tendencies. Incidence of DHF was more with secondary Dengue infection than the primary dengue infection. The frequency of complications was high in the patients with secondary dengue infection than the primary infection. CONCLUSION: In our present study classical dengue fever was most common presentation followed by DHF and DSS. Hypotension, hemorrhagic spots, positive tourniquet test, jaundice, pleural effusion, ascites, neck stiffness are the common findings on examination associated with complicated forms of dengue. Bleeding, shock, hepatitis, polyserositis, meningitis, pneumonia are the complications seen in severe forms. On investigation Deranged liver function test, renal function test, secondary dengue infection, thickened gall bladder wall, hepatosplenomegaly on ultrasound abdomen, pleural effusion and bronchopneumonia on chest radiogram are associated with DHF and DSS. INTRODUCTION: Dengue fever is an arthropod borne viral fever. It is acquiring epidemic proportion in this part of the world and it has become major public health problem with high mortality. Estimates suggest that 50 million cases of dengue infection and 500, 000 cases of dengue hemorrhagic fever occur in Asian countries 1 . It is vital to recognize at the earliest the signs and symptoms, alteration in biochemical parameters and multisystem involvement pattern in dengue to reduce the mortality. In 1998 WHO reported, around 1.2 million cases of Dengue fever and DHF with 3, 442 deaths. In 2001 alone, there were more than 609 000 reported cases of dengue in the Americas, of which 15 000 cases were DHF and incidence is increasing in 2001, Brazil reported over 390 000cases including more than 670 cases of DHF. About 2500 million people are now at risk from dengue. WHO currently estimates there may be 50 million cases of dengue infection every year, with 400, 000 cases of DHF, out of whom more