Abstract
Background: This study was conducted to elucidate the clinical features, laboratory parameters and management outcome of dengue patients admitted in a tertiary care center of Nepal.
 Methods: This was a retrospective descriptive study in dengue patients aged 12 years or more who were admitted in Tropical Wards and Intensive Care Unit of Chitwan Medical College Teaching Hospital (CMCTH), Chitwan, Nepal from November 2016 to December 2017. Diagnosis of dengue was confirmed by positive NS1 antigen or ELISA IgM or both. The required data were retrieved from patient’s medical records and laboratory data base. Data analysis was performed by using IBM-SPSS 20.
 Results: Of 60 patients, majority (65%) were male. Forty-one (68.33%) patients were diagnosed by positive NS1 and 18 (30%) were ELISA IgM positive. In the year 2017, highest numbers of cases (20, 33.33%) were in the month of November, followed by 14 cases (23.33%) in October. Similarly, in the year 2016, dengue cases peaked in the month of November. All patients had fever as a presenting complaint. Other common presenting features were myalgia 42 (70%) and headache 32 (53%). Thrombocytopenia was observed in 52 (86.66%) patients followed by leucopenia in 41 (68.33%) cases. Elevation of AST and ALT were found in 45 (75%) and 38 (63.33%) patients respectively. Only 2 patients (3.3%) had dengue with warning signs. Four (6.8%) patients needed platelet transfusion. No mortality was observed.
 Conclusions: Majority of dengue patients had thrombocytopenia, leucopenia, and elevated AST and ALT. Only two patients had dengue with warning signs. Hospital mortality was not documented.
Highlights
Dengue is a mosquito-borne viral disease that is rapidly spreading in recent years
3 The clinical presentations of dengue ranges from acute undifferentiated febrile illness, classic dengue fever to dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS).[4]
It was reported that nearly 10% of the dengue patients had developed dengue hemorrhagic fever and or warning signs.[12]
Summary
Dengue is a mosquito-borne viral disease that is rapidly spreading in recent years. Dengue virus (DV) is an RNA virus of genus Flavivirus with four serotypesDV-1, DV-2, DV-3 and DV-4 which is transmitted by bites of female mosquitoes, most commonly by Aedes agepticus and to a lesser extent by A albopictus.[1]. In 2010, there were 917 confirmed cases of Dengue mainly from Chitwan, and Rupandehi districts situated in southern part of Nepal bordering India.[10] The occurrence of dengue fever in Nepal is high during rainy season, between July and December.[11] It was reported that nearly 10% of the dengue patients had developed dengue hemorrhagic fever and or warning signs.[12] Dengue has been recognized as an emerging disease and one of the causes of acute undifferentiated febrile illnesses. This study was conducted to elucidate the clinical features, laboratory parameters and management outcome of dengue patients admitted in a tertiary care center of Nepal. Conclusions: Majority of dengue patients had thrombocytopenia, leucopenia, and elevated AST and ALT.
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