The paradigmatic shift in the clinical profile of dengue patients: a prospective observational study from a tertiary care center in north India

Abstract

Background: Dengue a vector-borne viral disease transmitted by mosquito and has several complications causing fatalities and a bad impact on society. The paucity of studies in Uttar Pradesh and lack of epidemiological data necessitated to take up this prospective study. Thus, the current study looked into the causes of heavy prevalence, urban v/s rural ratio, gender difference, various complications to formulate a strategy to limit the severity of the disease by early diagnosis and rapid intervention. The fever caused by dengue is characterized by body ache, petechial rashes, myalgia, and nausea and vomiting. There can be varied manifestations of dengue involving the lung, pleura, peritoneum, pericardium, and complications of liver, kidney, brain, muscle, eye, and other organs. The disease is characterized by thrombocytopenia, dehydration, bleeding tendencies, shock, and multiorgan dysfunction. Current estimates reports about 40% (2.5-3 billion) of the world population are at risk. Purpose: The study is aimed at detecting clinical signs and symptoms of patients with dengue fever presenting to TMU teaching hospital between January 2019 to December 2019. Material and Methods: A prospective observational study was undertaken in serologically confirmed cases of dengue. The disease was analyzed for its clinical profile, required investigations were done and evaluated. Results: In the present study the clinical outcome was: 1) Dengue fever without warning sign was (29.46%). 2) Dengue fever with a warning sign (57.87%). 3) Severe dengue fever (12.12%). Mortality noted in the present study was 1.8%. Bleeding manifestations were noted in 8.2% of patients. Thrombocytopenia (<100,000) was noted in (85.85%) patients. Fever was the presenting complaint in the majority of the patients (99.3%). Fever was followed by myalgia (91.9%), headache (58.8%), arthralgia (28.2%). Conclusions: Patients of dengue presented with fever, headache, myalgia, nausea, vomiting. Bleeding manifestations were looked for. Lab findings like leucopenia and deranged liver function test were more than other studies.