Complication Of Dengue Fever Research Articles

Spontaneous splenic rupture as a complication of dengue fever

Dengue is a mosquito-transmitted virus and the leading cause of arthropod-borne viral disease in the world. Clinical manifestations can vary from asymptomatic disease to severe illness and death. Dengue is also known to cause myocarditis, hepatitis, and neurological manifestations, and rarely to cause splenic rupture. We report a 34-year-old man with splenic rupture complicating dengue fever which was managed conservatively with excellent outcome.

RELATIONSHIP BETWEEN MYOCARDITIS AND DENGUE

Introduction: Myocarditis, an inflammation of the heart muscle, can arise as a complication of dengue fever, a mosquito-borne disease. It is essential to adopt a multidisciplinary approach to monitor and treat cardiac complications in patients with dengue fever at an early stage. Diagnostic tests include serology, PCR, and echocardiography. From a review study on cardiac involvement in dengue, it was found that this complication is significant and demands a multidisciplinary approach . Objective: The objective of this study was to conduct a comprehensive integrative review to explore the relationship between myocarditis and dengue fever. Methodology: Articles were searched in databases such as PubMed, Google Scholar,Ministry of Health, and ScienceDirect, using search terms in both Portuguese and English. Out of 122 articles found, 74 were selected for analysis, and 13 were included in the results. Results: The studies examined the relationship between dengue fever and myocarditis, with a focus on the cardiovascular manifestations of dengue fever and the prevalence of myocarditis in infected patients. Analysis of the articles revealed a significant prevalence of myocarditis in patients with dengue, highlighting a strong association between the two conditions. Discussion: Dengue patients frequently present with cardiac issues such as myocarditis, necessitating early detection to prevent serious complications. Effective vector control is crucial to reducing the impact of dengue. These findings provide direction for future research and the development of targeted therapies. Conclusion: Early identification of cardiac complications, such as myocarditis in dengue patients, is crucial to reducing morbidity and mortality. Ongoing research into the pathophysiological mechanisms is vital for the development of specific treatments. The study concludes that myocarditis is commonly associated with dengue, requiring meticulous medical monitoring.

CLINICAL MANIFESTATIONS AND LABORATORY PROFILE OF DENGUE FEVER CASES AT THE TIME OF PRESENTATION IN TERTIARY CARE HOSPITAL

Dengue is the most common arboviral disease worldwide in tropical and subtropical regions. Clinical manifestations of dengue fever are mild illnesses like classical dengue fever and severe illnesses like dengue shock syndrome, and dengue hemorrhagic fever. The study was aimed to determine the clinical manifestations and laboratory parameters of patients with Dengue fever Materials And Methods: This prospective study was conducted at a tertiary teaching hospital, Nellore over 6 months. All the patients above the age of 14 years who were diagnosed with Dengue with a positive result for NS1Ag or IgM or IgG antibodies were included. All the necessary clinical and laboratory investigation parameters of the patients were noted and the data was analyzed by frequency and percentage. Results: During the study period, a total of 73 dengue cases were included in the study. Of these, there were 38 (52%) males and 33 (48%) females between 15 and 80 years of age. The most common clinical presentations were fever (100%), headache 56 (76.7%), myalgia 52 (71.2%), and nausea/vomiting 46 (63%). The common hematological findings were thrombocytopenia 58 (79.4%), followed by raised liver transaminases 42 (57.5%), leucopenia 37 (50.6%), leucocytosis 22 (30.1%) and raised hematocrit 21(28.7%) Conclusion: Fever, headache, and anorexia are the most prevalent clinical manifestations of Dengue fever. Low platelet count, raised liver transaminases, and a rise in hematocrit are the most prevalent laboratory abnormalities. Early detection and monitoring of dengue cases can prevent the serious complications of dengue fever.

Exploring the Various Radiological Observations and Appearances in Patients with Dengue Fever; A Retrospective Observational Approach

Objective: To assess the range of radiological observations in patients testing positive for dengue serology. Methodology: This retrospective, observational study was conducted at Islamabad Diagnostic Center, Islamabad from September 2022 to March 2023. The Ethical Committee approved this study. All the individuals who arrived at the IDC, Islamabad, complaining of fever and tested positive for dengue serology, from September 2022 to March 2023, were included in our study. A total of 240 patients met these criteria. Patient details, including age and gender, were obtained from the center’s computer system. Results: Severe cases of dengue fever, including thrombocytopenia, were observed in 62 out of 240 patients (25.83%), while mild clinical presentations were noted in rest of the 178 patients (74.16%). The most mutual radiological outcome was wall edema of the gall bladder (figure 2a), seen in 113 out of 240 patients (47.08%). This was followed by ascites (2b), that were observed in 38.33% (n=92) cases. Hepatomegaly was noted in 10.83% (n=26) (2c), splenomegaly in 3.75% (n=9) (2d) respectively. Conclusion: Dengue fever presents with a variety of manifestations. Imaging techniques, especially ultrasound, can be employed to promptly identify the characteristics and complications of dengue fever in emergency situations, even when serological tests are unavailable or delayed.

A case of unusual hemorrhage as a complication of dengue fever in a tertiary hospital in Dhaka

Common bleeding complications of dengue hemorrhagic fever are epistaxis, gum bleeding, gastrointestinal bleeding, menorrhagia, hematuria.1 Major hemorrhage like intracranial hemorrhage have been documented but rare. We present here a case of a 24 year old man with complaints of high grade intermittent fever for 5 days, upper abdominal discomfort for 3 days and swelling of right upper limb for same duration. Laboratory investigations revealed a positive dengue serology, thrombocytopenia and elevated transaminases. USG of the hand revealed a hematoma involving the right upper arm. The patient was managed conservatively with elevation and immobilization of the upper limb and recovered gradually. J MEDICINE 2024; 25: 100-101

Ophthalmic complications during the dengue epidemic in Reunion Island in 2020: a case series and review of the literature

IntroductionDengue is an arboviral disease transmitted by the dengue virus, whose vectors are Aedes aegypti and Aedes albopictus. The acute phase with its cohort of well-known symptoms is usually spontaneously favorable. Since 2020 in Reunion Island, a new symptom has appeared: the ocular damage of dengue fever, which has already been described in South Asia and South-East Asia. We therefore decided to describe the clinical, biological, ophthalmological, therapeutic, and outcomes of patients with ocular manifestations during dengue fever in Reunion Island in 2020.Patients and methodsThis was a retrospective observational study. Patients were included from January 2020 to August 2020 and then reassessed by teleconsultation 1 year later. The patients were identified from the French public health surveillance network by all ophthalmologists on the island. Medical data were collected directly from medical records.ResultsTwenty-eight patients were included. The mean age was 41.9 years. Ocular involvement occurred approximately 9.2 days after the onset of dengue symptoms. The main symptoms were scotoma (71.4%) and sudden decrease of visual acuity (39.2%). Eighteen patients (64.2%) had macular involvement. Fourteen patients were treated with oral or intravenous corticosteroids. Twenty-two (78.5%) patients were evaluated by telephone one year later. Scotoma and decreased visual acuity persisted in 15 patients. Thirteen patients (59%) were bothered by night driving, 32% of patients had reading difficulties and 27% of patients became sensitive to prolonged exposure to screens.ConclusionOcular complications of dengue require early and collegial management to limit the risk of long-term sequelae. Further studies on the characteristics and complications of dengue fever are needed to better understand this disease.

CLINICAL PROFILE OF NEUROLOGICAL INVOLVEMENT IN DENGUE IN CHILDREN ADMITTED TO A TERTIARY CARE CENTER

Background: Dengue is the second most common mosquito-borne disease affecting human beings after malaria. Transmitted by mosquitoes of the genus Aedes, clinical manifestations range from an asymptomatic state to a severe haemorrhagic fever. A change in the spectrum of clinical manifestations has been recently noted with neurological manifestations being recognized frequently 12.The incidence of encephalopathy and encephalitis, the most common neurological complications of dengue,has been estimated to be between 0.5 and 6.2%12 Aims And Objectives: 1.To study the clinical profile of Neurological involvement in children with dengue. 2.To study the Neurological complication in children with dengue infections. Study Design: prospective observational study Participants: The data was collected from 50 patients who had neurological manifestations and serologically proven dengue antibodies admitted in hospitals attached to M.R. Medical college Kalaburagi Results: Neurological manifestation and complications in dengue fever observed in 50 cases (13%).female preponderance is seen (ratio of 0.9:1).common symptoms were fever with seizures (60%), headache (56%), vomiting (70%), altered sensorium (40%) and blurring of vision (20%). clinical signs elicited were hepatomegaly (68%), splenomegaly (52%), oedema (52%), lymphadenopathy (20%). Mean GCS found to be 11.2. complications observed in study subjects were encephalitis (56%) followed by encephalopathy (36%), meningitis (4%), meningoencephalitis (4%), cranial nerve palsy (4%), intracranial bleed (2%). mortality observed in 4 cases (8%). Conclusion: Neurological manifestations in dengue fever is widespread and it may progress to life threatening complications like encephalopathy, encephalitis, Intracranial bleed etc through various diverse mechanisms. However, awareness is required for prevention, early recognition, and timely therapeutic intervention to prevent complications and mortality.

Etiology, Treatment and Complications of Dengue Fever: A systematic Analysis

Etiology, Treatment and Complications of Dengue Fever: A systematic Analysis

Immature platelet fraction as predictor of platelet recovery in dengue fever

Dengue fever is caused by dengue virus—a mosquito-borne flavivirus and transmitted by Aedes aegypti and Aedes albopictus, and estimated 390 million cases of dengue infection occur each year globally, with 96 million cases being considered severe. Thrombocytopenia has always been one of the criteria used by WHO guidelines as a potential indicator of clinical severity. Thrombocytopenia is a common cause of concern in dengue to both patients and attending clinicians. To avoid hemorrhagic complications in dengue fever with thrombocytopenia, prophylactic platelet transfusions are administered. Even though it saves lives, platelet transfusions have their own dangers. In order to prevent unnecessary platelet transfusions, a lot of study has been done on Immature Platelet Fraction (IPF) as a predictor of platelet recovery. IPF is a measurement of reticulated platelets that represents the rate of thrombopoiesis. The rapid detection of IPF can lower the danger of platelet transfusion.

Ocular manifestations of dengue fever in Bangladesh during its out break

Dengue fever, borne by Aedes aegypti mosquito, is one of the most common and most prevalent forms of flavivirus infections in humans, endemic in tropics and warm temperate regions of the world. We report a spectrum of ocular manifestations of dengue fever along with its associated laboratory findings. To study the ocular manifestations associated with dengue fever. This study was conducted in 600 patients hospitalized with diagnosis of dengue fever over a period of 3 months from March 2019 to May 2019. All patients underwent complete evaluation with respect to systemic and ophthalmic examination in different institutions of Bangladesh. A total of 600 patients were diagnosed with dengue fever; of which, 375 (62.5%) were men and 225 (37.5%) were women. Mean age was 32 years (20–60 years). Only 195 patients (32.7%) had complaints of retrobulbar pain in the eyes. 10 patients (1.67%) had blurring of vision. Ocular findings were present in 340 patients (56.7%). Most common anterior segment findings were subconjunctival haemorrhage in 275 patients (45.8%). Posterior segment findings were present in 80 patients (13.3%); of which, 70 (87.5%) had retinal haemorrhages. Ocular changes had resolved in all the cases, which came for follow-up in 8–10 weeks. It was mostly attributed to the improving platelet count. The incidence of ocular complications in dengue fever is increasing, hence all patients with dengue should be referred to an ophthalmologist to prevent any sight-threatening BSMMU J 2022; 15(1): 16-19

Using first-contact serum ferritin to predict severe thrombocytopenia in dengue patients: determination and validation in independent cohorts

Background Severe thrombocytopenia and associated haemorrhage are dreaded complications of dengue fever. The identification of a biomarker that can predict, or rule out, its subsequent development can help identify at-risk individuals. Methods 200 dengue patients were included – the first 100 in the deterministic cohort and the latter, the validation cohort. Serum ferritin levels were measured at first presentation. Platelets were monitored serially. Data from the first cohort was used to determine the optimal ferritin level to predict significant thrombocytopenia (<20,000/µL). This threshold was validated in the second cohort. Results In the deterministic cohort, a ferritin threshold of 593 ng/mL predicted severe thrombocytopenia with a sensitivity of 93.33%, negative predictive value of 98.18% and negative likelihood ratio (LR-) of 0.10. In the validation cohort, the sensitivity and negative predictive value of this threshold were both 100%. The power of the study (determined post-hoc) for each cohort was 98.4% and 86.4% respectively. Conclusion First-contact ferritin consistently identified at-risk individuals. Individuals with ferritin levels below 593 ng/mL were unlikely to develop severe thrombocytopenia independent of clinical presentation.

English

BACKGROUND Dengue fever (DF) is caused by a flavivirus and is transmitted to humans by the vector Aedes aegypti. Industrialization and unplanned urbanization have led to an increase in incidence of DF. DF can lead to organ-specific complications especially in those with co-morbidities. The present study was done to estimate the prevalence of organ-specific complications in DF and determine the association of comorbidities and development of organ-specific complications. METHODS This is a prospective cross-sectional observational study. 148 participants with DF as confirmed by NS1 antigen or dengue IgM presenting to medicine outpatient department of Government Medical College, Trivandrum were enrolled in the study after obtaining written informed consent and obtaining Institutional Ethics Committee approval. Examination findings, laboratory investigations [complete blood count (CBC), liver &amp; renal function tests (RFT)], chest radiograph, ultrasonography (USG), magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) examination were done as routine procedures wherever necessary, and the details were collected in case record forms. Data was analysed using Rafter assessment of normality and homogeneity and chi square test was used to determine the association between parameters and organ specific complications. P &lt; 0.05 was considered statistically significant. RESULTS Acalculous cholecystitis (29.1), hepatitis (4.7 %), aseptic meningitis (4.1 %), encephalopathy (4.1 %), myocarditis (3.4 %), encephalitis (2.7 %), acute kidney injury (2 %), acute respiratory distress syndrome (2 %), pericardial effusion (1.4 %), pleural effusion (1.4 %) and conduction anomalies of heart (0.7 %) were the organ specific complications associated with DF. Participants with co-morbidities were at a higher risk of developing organ-specific complications when compared to the healthier individuals. CONCLUSIONS Acalculous cholecystitis was the most common complication associated with DF and the presence of co-morbidities was a significant risk for development of complications. Proper planning for vector control measures especially during highrisk seasons would reduce the transmission of the disease and reduce the healthcare burden, mortality and morbidity associated with dengue fever. KEY WORDS Dengue Fever, Organ Specific Complications, Acalculous Cholecystitis, Hepatitis, Meningitis

English

BACKGROUND Dengue fever is a vector-borne disease common in the tropics. It is known to have an adverse effect on pregnant women with unfavourable foetal outcomes. However, only a few studies are addressing this problem. Many of the studies had confounding factors such as the simultaneous occurrence of other vector-borne diseases and maternal health conditions. Therefore, the actual impact of dengue fever on pregnancy and pregnancy outcome is not clear. We wanted to study maternal and foetal outcomes in dengue positive pregnant females. METHODS This is a retrospective study done over 6 months in a tertiary care institute. Data regarding demography, obstetric history, biochemical parameters / blood investigation and pregnancy outcomes were collected and analysed. RESULTS Most of the dengue positive women presented with fever and thrombocytopenia in 44 % of cases. Obstetric complications such as preterm labour, abruption and postpartum haemorrhage (PPH) were common. Caesarean section rate was increased and the most common indication was foetal distress. The need for new-born intensive care unit (NICU) admission for new-born and foetal death was also increased. No evidence of congenital anomaly was found in the study. CONCLUSIONS Antenatal complications like preeclampsia, oligohydramnios; intrapartum complications like abruption, DIC, foetal distress and immediate postpartum complications like postpartum haemorrhage, need for blood, platelet transfusion were common in women with a history of dengue fever especially more in the low platelet group. The maternal and foetal outcomes were compromised and both required intensive care. A high index of clinical suspicion is essential in pregnant women presenting with fever and thrombocytopenia. Early diagnosis and management are essential. KEY WORDS Dengue Fever, Dengue in Pregnancy, Complications of Dengue Fever in Pregnancy

P-OT025. A rare case of dengue encephalopathy in pregnant woman

Introduction . Dengue fever has been known for more than two decades as a tropical endemic infection caused by the dengue virus that affected from Aedes aegypti . Complications of dengue fever are common and usually related to renal and hepatic dysfunction. Encephalopathy is a rare complication. Here we report an unusual case of pregnant woman with dengue encephalopathy. Results . A 28-year-old female, G1P0A0, consulted by the anesthetic division with loss of consciousness. Prior to that, she had acute fever with history of acute progressive cephalgia and positive results of IgG and IgM dengue antibody. She was 20 weeks of pregnancy. On examination she was stuporous (E2V2M5). Lateralization, pathological reflex, and meningeal signs were not found. Laboratory examination showed thrombocytopenia 23 × 10 3 /µl, increased transaminase enzyme, hypokalemia 2.53 mmol/L, and hypoalbuminemia 2.35 gr/dL. Head CT Scan showed cerebral edema. During hospital care, she was monitored closely. Careful fluid management was carried out with additional treatment consisted of thiamine 100 mg/12 h, piracetam 800 mg/12 h, folic acid 2 × 1 mg, and transfusion of albumin and premix KCL. Patient condition was improved after 7 days of hospital care. The encephalopathy lasted for 5 days. Patient was discharged with full of consciousness and the baby was safe. Conclusion . Encephalopathy is a rare manifestation of DHF. However, it is a significant diagnostic challenge when it presents in atypical form, especially during pregnancy. It was first reported in 1976, and worldwide literature search shows the various incidence of dengue encephalopathy from 0.5% to 6.2% with a mortality rate up to 40%. The complications of dengue in pregnancy have been scarcely studied. There are increased risks of maternal hemorrhage, preterm labor and stillbirths. Dengue should be the differential diagnosis even a pregnant women presents with fever and altered sensorium especially in endemic areas like Indonesia.

English

BACKGROUND Dengue is a major public health concern in tropical Asian countries and a most rapidly spreading mosquito borne viral disease with a 30 fold increase in global incidence over the last five decades. Dengue is among the ten leading causes of death in children ranging from 1 to 15 years of age in tropical Asian countries. Complications of dengue fever are common in children. But very limited studies are available on paediatric populations. The virus or non-structural protein (NS1) interacts with platelets and coagulation factors. A combined effect of mild disseminated intravascular coagulation, liver damage and platelet dysfunction results in bleeding in dengue fever. With this scientific knowledge background, the present study was undertaken to identify and document the changing pattern of dengue infection in paediatric age group with a special emphasis on laboratory findings of dengue cases in paediatric age group. METHODS The present descriptive study was conducted for two years in a state run paediatric referral hospital. The sample was purposive by design and consisted of patients who have been diagnosed as having dengue fever with warning signs and admitted. RESULTS Fever was typically high grade (&gt; 103 F) and most patients presented with warning signs within 5 days of illness (64.2 % in year 2016 and 76.6 % in year 2017). Persistent vomiting and abdominal pain were the most common warning signs in both the years. Thrombocytopenia was the commonest laboratory finding. Bleeding in study subjects lead to &lt; 50000 / cu mm platelet count. Most common bleeding was gastrointestinal bleeding (39.2 % of study subjects with platelet count &lt; 50000 / cu mm presented with G. I bleeding). CONCLUSIONS Dengue illness comes with varied presentation. Atypical presentations can delay the diagnosis. Early recognition of warning signs keeping the atypical presentation in mind is important. KEYWORDS Dengue Fever, Paediatric Age Group, Non-Structural Protein (NS1), Thrombocytopenia

Optic neuritis as the ocular manifestation of dengue infection: a case report

Optic neuritis is characterized by decreased vision, impaired colour perception, relative afferent pupillary defects, and scotoma. Optic neuritis following dengue infection is rare and might be underdiagnosed. The pathophysiology of optic neuritis after dengue infection is still unclear and there are only a few reports. We report a case of bilateral simultaneous optic neuritis in a young female adult following dengue haemorrhagic fever. On presentation, she complained of blurred vision, pain around the eyes, central scotoma, and progressively worsening visual acuity to no perception of light in both eyes. The next day, laboratory examination showed leucopoenia (6.74 [4.5–11.5 103/μL]) and lymphocytosis (52.7 [18–42%]), suggesting viral infection with positive anti-dengue IgM and IgG. The patient received intravenous pulse steroid therapy according to the Optic Neuritis Treatment Trial. At 3 months follow-up, best corrected visual acuity improved to 6/6, with pale optic discs but normal perimetry. Although complications of dengue fever in the eye are rare, early recognition must be established to prevent permanent vision loss.

HEMOPHAGOCYTOSIS: AN UNUSUAL COMPLICATION OF CLASSICAL DENGUE FEVER WITH ACUTE LIVER FAILURE.

Dengue is a vector-borne disease caused by dengue virus. It has a diverse presentation and usually presents as an asymptomatic, self-limiting disease. Among the unusual presentations, hepatic dysfunction is well reported. Complications of dengue fever can be protean and life-threatening. Dengue may cause bone marrow suppression leading to thrombocytopenia, leukopenia and anemia in acute phase of illness; and increased hematocrit due to capillary leakage, but these changes are self-limiting and require no further investigations and specic treatment. Dengue associated Hemophagocytic lymphohistiocytosis (HLH) is a rare complication of Dengue haemorrhagic fever or Dengue shock syndrome. Diagnosis of secondary HLH (sHLH) due to dengue is usually challenging and delayed as initial clinical symptoms mimic sepsis and systemic inammatory response syndrome (SIRS). Delayed or no treatment of sHLH has a poor outcome. We present an unusual case of classical dengue fever presented as Acute liver failure (ALF) with encephalopathy, later complicated by sHLH.

Foveolitis as a complication of dengue fever

Foveolitis as a complication of dengue fever

Study of clinical manifestations, atypical presentation and complications of dengue fever

Study of clinical manifestations, atypical presentation and complications of dengue fever

SPECTRUM OF COMPLICATED DENGUE FEVER IN RAWAL INSTITUTE OF HEALTH SCIENCES ISLAMABAD: A CROSS SECTIONAL STUDY

ABSTRACT&#x0D; BACKGROUND &amp; OBJECTIVE: Pakistan has been facing frequent dengue fever epidemics for the last decade. The current study aims at various complications of dengue fever and their association with age, gender, serology, duration, and symptoms.&#x0D; METHODOLOGY: This cross-sectional study was conducted at the Medicine department, RIHS Islamabad, over eight months of duration after ethical approval. The dult indoor dengue fever cases were selected by consecutive sampling and informed consent obtained. Cases with malaria co-infection, hematological disease, and severe systemic illness were excluded. The symptoms, hematological counts, serology (dengue NS-1, IgG, and IgM), liver function tests, coagulation profile, pneumonia, and pericardial effusion, were documented. Data were analyzed by SPSS V-22.&#x0D; RESULTS: Among 75 cases, 19(25%) were females and 56(75%) males. The mean age was 33.5+12.7. The mean duration of symptoms was 5.4+2.0 days. Dengue NS-1 was positive in 45(60%), IgM in 22(29%), and IgG in 8(11%). Symptoms observed were fever 97%, headache 53%, pain abdomen 35%, vomiting 48%, rash 17%, and body aches 39%. Complicated Dengue fever was seen in 21(28%). Complications include gum bleed 12%, liver impairment 6.6%, gastrointestinal bleed 5%, per-vaginal bleed 4%, epistaxis 4%, hematuria 3%; pleural effusion, ascites and pneumonia 2.6% each, pericardial effusion 1.3% and one expiry. Age, gender, dengue serology, and hematological profile wasn’t found to be associated with complications.&#x0D; CONCLUSION: Complications are frequent in indoor dengue cases that include hemorrhagic complications, liver impairment, effusions, and pneumonia. Early presentation to the hospital may be helpful to screen for impending complications with improved morbidity and better patient care.