Manifestations Of Dengue Fever Research Articles

Lung Manifestation of Dengue Fever: A Retrospective Study.

Introduction Dengue fever, caused by the dengue virus transmitted by Aedes aegypti mosquitoes, is a significant public health concern globally. Its resurgence in recent years, particularly in low- and middle-income countries, has led to increased morbidity and mortality rates. Atypical manifestations, involving the cardiac, liver, gut, renal, blood, bone, nervous, and respiratory systems, in dengue, can complicate both diagnosis and management. This study aimed to investigate the incidence of lung manifestations in dengue-infected individuals and their correlation with patient outcomes. Background The prevalence of dengue fever has risen dramatically over the past two decades, with Asia bearing the brunt of the burden, particularly India. The pathophysiology of lung complications in dengue remains unclear but is thought to be related to capillary leak syndrome and thrombocytopenia. Studies suggest that respiratory symptoms may be associated with severe cases and increased mortality rates. Despite limited research in India, understanding lung manifestations in dengue is crucial for improving diagnostic accuracy and patient care. Methods A retrospective study was conducted at K.S. Hegde Hospital, a tertiary care facility located in Mangalore, India, involving patients aged 18 years and above diagnosed with dengue fever between January and December 2019. Data gathered comprised patient demographics, clinical symptoms, laboratory findings, imaging results including radiographs, computed tomography (CT) scans of the chest (if accessible), ultrasound examinations of the chest and abdomen, and 2D echocardiograms, as well as patient outcomes. Diagnosis of lung manifestation was established through clinical assessment, chest X-ray interpretation, and ultrasound of the chest. Statistical analysis was conducted using SPSS Statistics (version 20), with a significance set at p<0.05. Results Out of 255 dengue cases, 10.19% (n=26) exhibited pulmonary manifestations, with pleural effusion being the most common. Older age (>50 years) and comorbidities were associated with a higher incidence of lung involvement. Respiratory symptoms, such as breathlessness, were more prevalent in patients with pulmonary complications. Laboratory parameters indicated distinct profiles in patients with lung manifestations, including elevated total count, urea, bilirubin, and liver enzymes, and reduced platelet counts. Mortality rates were higher in patients with lung involvement, older age, and comorbidities. Discussion The study findings highlight the importance of recognizing respiratory symptoms in dengue fever, particularly in older patients and those with underlying health conditions. The association between pulmonary involvement and adverse outcomes underscores the need for early detection and appropriate management strategies. Future research should focus on elucidating the pathophysiology of lung complications in dengue and developing targeted interventions to improve patient outcomes. Conclusion Lung manifestations in dengue fever represent a significant clinical challenge and are associated with increased morbidity and mortality. Early recognition of respiratory symptoms, along with prompt diagnostic evaluation and appropriate management, is essential for improving patient prognosis. Further studies are warranted to deepen our understanding of lung involvement in dengue and optimize therapeutic approaches to mitigate its impact on patient outcomes.

Facial nerve palsy: An atypical presentation of dengue fever

Dengue fever is a grave public health concern in tropical countries. The disease spectrum of dengue fever is multi-systemic, although neurologic complications of dengue fever is relatively uncommon. The pathogenesis of neurologic manifestations in dengue fever is not well understood and may be due to the neurotrophic effect of the virus, or related to the systemic effects of dengue infection, and immune mediated. Here in, we discuss the occurrence of isolated 7th cranial nerve lower motor neuron type palsy in a 23-year-old lady suffering from dengue fever. To date, there are very few case reports citing the involvement of facial nerve in dengue fever.

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.

Panophthalmitis in Patient With Dengue Hemorrhagic Fever

Abstract Dengue fever can lead to serious complications of severe bleeding, massive capillary leakage causing dengue shock syndrome and vital organ involvement. Ocular manifestations in dengue fever are rare but may sometimes lead to permanent disability. Here we report a case of rare complication of dengue fever in a 35-year-old man presenting with panophthalmitis, leading to rapidly progressive and painful visual loss. With this case, it can be emphasized that early identification and management of dengue complication may prevent vision loss.

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

Dermatological Manifestations in Dengue Fever

Objective: To assess the frequency of skin &amp; mucosal manifestations in dengue fever patients. Study design: Cross-sectional study. Place and duration of study: Patients admitted in dermatology &amp; medicine departments of Akhtar Saeed Trust Hospital Lahore were included in the study. Method of study: This cross-sectional study was conducted in departments of dermatology &amp; medicine at Akhtar Saeed Trust Hospital Lahore for a period of 3 months from Separation 3021 till December 2021. After taking consent a total of 60 patients of suspected dengue fever were enrolled for this study. Their demographic data was noted down with skin &amp; mucosal findings in a predesigned performa. Their frequencies were calculated &amp; analysed in SPSS version 11. Results: Out of 60 patients, 38 patients (63.3%) were males &amp; 22 patients (36.6%) were females. Mean age of patients was 35.20 years. 13 patients (21.6%) had no skin findings and 47 patients (78.4%) had skin findings. The commonest skin finding was pruritus present in 24 patients (40%), followed by facial flushing in 15 patients (25%). Petechial rash and burning sensation were found in 7 patients (11.6%). Among the mucosal findings, eye involvement was the commonest present in 15 patients (25%). Conclusion: Cutaneous and mucosal manifestations are an important part of dengue fever. These findings also help in assessing the disease progress. Key words: Dengue fever, cutaneous manifestations.

Bilateral internuclear ophthalmoplegia developing as a manifestation of dengue fever and treatment by modified Nishida procedure: A case report and review of the literature

<br>Typical causes of internuclear ophthalmoplegia (INO) include demyelinating conditions, with inflammation, infection, and trauma being less common causes. Diplopia associated with INO severely impacts the patient's quality of life. Orthoptic treatment usually fails; therefore, appropriate surgical treatment should be considered. We report the unique case of a 25-year man with bilateral INO developing as a manifestation of dengue fever-related encephalitis and its successful treatment by modified Nishida procedure.<br>

CARDIAC MANIFESTATIONS OF DENGUE FEVER IN CHILDREN

Introduction: Dengue fever represents a signicant public health problem in tropical and subtropical regions. 70% of total cases are from Asia, especially India. Caused by 4 dengue virus serotypes( DENV-1, DENV-2 DENV-3 and DENV-4), DENV-2 being the most prevalent in India. Incidence and range of cardiac manifestations in dengue fever vary widely. Aims &amp; objectives: To study the incidence and range of cardiac manifestations of dengue fever in children. Material &amp; methods:This is an observational study, conducted in department of pediatrics at National Institute of Medical Sciences &amp; Research, Jaipur in study period of 18 months. A total of 94 patients were included in the study fullling the inclusion criteria. Results: The overall incidence of cardiac manifestations was found to be 31.9%. The incidence of cardiac manifestations in dengue without warning signs was 4.4%, in dengue with warning signs was 52.5% and in severe dengue was 77.7%. Conclusion: Incidence of cardiac manifestations increases with increase in disease severity

Atypical Manifestations of Dengue Fever in Children

Abstract Objective The burden of dengue fever (DF) is increasing rapidly worldwide. Several atypical manifestations of DF are being increasingly reported but there are no clear guidelines on their definition and management. Their timely detection and appropriate management might improve outcomes. We describe here our experience in managing atypical manifestations of DF in children and their outcomes in a teaching hospital in South India. Methods A retrospective chart review of children (1 month–18 years) hospitalized, between August 2017 and March 2018 with a diagnosis of DF (NS1 antigen or immunoglobulin M antibodies positivity), was done. The clinical details of the atypical manifestations are described. Results During the study period, 925 children were hospitalized with DF, of which 94 (10.16%) had severe dengue and 2 (0.21%) died. Among the 925 children, 7 (0.75%) had cardiac, 5 (0.54%) had neurological, 5 (0.54%) had hepatic, and 31 (3.3%) had immunological (infection-associated immune dysregulation) manifestations. Conclusion Most children with atypical manifestations of DF recover with supportive management. There is a need for a clear definition of atypical manifestations so that large prospective multicenter studies on incidence, optimum management, and outcomes can be done.

Clinical study of cardio vascular manifestations in dengue fever

Clinical study of cardio vascular manifestations in dengue fever

A clinical and biochemical laboratory profile to measure the severity of dengue fever and their outcome

Background: To identify various manifestations of dengue fever, complications, and to measure their association with laboratory findings.Methods: 100 cases of suspected adults between 20-70 years of age with clinical features suggestive of dengue infection and patients presenting with fever of acute onset (&lt;2 weeks), pain abdomen, vomiting, rash, flushed appearance and bleeding manifestation were studied. All cases were followed up for the clinical and laboratory parameters and treated according to WHO guidelines.Results: 36 were classified as classical dengue fever, 33 as dengue haemorrhagic fever (DHF), 15 as dengue shock syndrome (DSS), and 16 as dengue-like illness (DLI) and the common age group was 30-40 year (50%). Most (66%) of the patients were male. The common presenting symptoms was fever 65%, vomiting (40%), abdominal pain (40%), myalgia (7%), etc. Hepatomegaly (53%), ascites (1%), splenomegaly (8%) was noted. The mean platelet in the present study was 41870 cells/cu mm. Elevated liver enzymes and elevated serum creatinine was found in complicated forms of disease. The prothrombin time ranged from 11-60 sec with a mean of 19.5 sec.Conclusions: The treatment of dengue is mainly supportive, but early institution and meticulous monitoring are the important steps for positive outcome. Much more awareness, vigilance and research in the diagnostic modalities are further needed to avoid unnecessary panic and platelet transfusions.

A study of ophthalmic manifestations in dengue fever

Dengue virus is a positive sense RNA virus of the flavivirus family with at least four distinct serotypes. It is the cause of dengue fever which is associated with headache, retro-orbital pain, joint and bone pain (hence

A study of various hepatic manifestations in dengue fever and their correlation with severity of dengue fever

Background: Hepatic involvement in Dengue is known with protean of manifestations ranging from hepatomegaly, elevated liver enzymes to fulminant hepatic failure. Aim of the study was to study the hepatic manifestations in children with dengue illness.Methods: This is a prospective Study with 60 Patients hospitalized with Dengue infection (Seropositive for Dengue). Dengue Seropositive patients are selected and examined for Hepatomegaly and Jaundice and subjected to complete blood count and Liver function tests were analysed.Results: Of 60 serologically confirmed cases hospitalized with dengue, were classified into (i)(DF), (ii) DHF I (iii) DHF II (iv) DHF III and (v) DHF IV. In our study, upon 60 seropositive cases were reported at our hospital during the study period of which 18 were DF, 12 were DHF I, 15 were DHFII, 8 were DHF III and 7 were DHF IV respectively. The Hematocrit levels were raised 20% from the baseline in four classes of Dengue and not raised in DF. Most commonly occurred in age group of 5-7 years. Hepatomegaly was the commonest clinical sign seen. Thrombocytopenia was seen in 88% of all cases. Serum total bilirubin was raised in 10% of subjects with severe dengue infection in DHF III and DHF IV. Serum SGOT and SGPT was raised in 63.3% and 56.7% of patients with dengue of all classes including DF respectively. Thrombocytopenia occurred in 75% of patients with dengue fever, 98% with warning signs and 100% in severe dengue.Conclusions: In developing country like India, incidence of dengue outbreaks is increasing. Hepatic involvement of varying degrees have been reported. As hepatic dysfunction in dengue is transient and reversible, early identification of the same would help to reduce life threatening complications. The role of hepato protective drugs in reducing morbidity and mortality should be analysed by further studies.

Clinical and laboratory manifestations of dengue fever with the outcome of the hospitalized patients at King Abdulaziz Medical City in Jeddah, Saudi Arabia

Clinical and laboratory manifestations of dengue fever with the outcome of the hospitalized patients at King Abdulaziz Medical City in Jeddah, Saudi Arabia

Epidemiological and clinical features of dengue fever outbreak in Jiangxi Province in 2019

Objective To investigate the epidemiological and clinical characteristics of 91 cases of dengue fever outbreak in Jiangxi Province in 2019, and to strengthen the management and prevention of dengue fever. Methods The clinical data, laboratory results and etiology tests of 91 patients with dengue fever from the Ninth Hospital of Nanchang, Zhangshu People′s Hospital, Fengcheng People′s Hospital and Nanchang County People′s Hospital from July 31, 2019 to September 27, 2019 were retrospectively collected. The t test was used for continuous variables and chi-square test was used for categorical variables. Results A total of 91 dengue fever patients were reviewed. The patients age ranged from 4 to 87 years old, and the majority were adult patients. Most patients were farmers and they all had mosquito-biting history. Local cases were the major source of this outbreak. The incubation time was (5.19±2.96) days. All patients had fever over 38 ℃. Thirty-eight (41.8%) patients developed rashes, mainly distributed on the limbs and trunk, and 15 patients (16.5%) developed myalgia and fatigue. The incidence of rashes in patients admitted in September was 15.9% (7/44), which was significantly lower than 68.1% (32/47) in July and August (χ2=25.262, P<0.01). The incidence of headache in patients admitted in September was 27.3%(12/44), which was significantly lower than 78.7% (37/47) in July and August (χ2 =24.206, P<0.01). Among the 91 patients, 64 (70.3%) patients had white blood cell counts less than 4×109/L, 14(15.4%) patients had platelet counts less than 50×109/L. The positive rate of dengue non-structural protein 1 (NS1) antigen was 100.0%(37/37), the positive rates of dengue antibody IgM and IgG were 50.0%(11/22) and 13.6%(3/22), respectively. Among the 113 serum samples tested for dengue virus RNA, 106 were identified with dengue virus type-1 and two were dengue virus type-2. In 22 patients who received tests within 7 days, the positive rate of NS1 antigen was 100.0% (22/22), the IgM and IgG positive rates were 50.0%(11/22) and 13.6% (3/22), respectively, and 19 patients were infected with dengue type-1. Among the IgM antibody positive cases, the onset days before sampling was (5.09±1.64) days, longer than that of IgM antibody negative cases ((2.82±1.83) days), with statistical significance (t=3.063, P=0.007). The onset time before sampling in dengue virus RNA-positive group was (3.53±1.87) days, which was shorter than that of RNA-negative group ((6.67±0.58) days), and the difference was statistically significant (t=2.839, P=0.013). Conclusions The dengue fever outbreak cases in Jiangxi Province in 2019 have typical clinical manifestations of dengue fever. Using the NS1 antigen test, IgM and IgG antibody tests and real-time fluorescent quantitative polymerase chain reaction for dengue virus genotyping during early onset of the disease can assistant clinicians in clinical management, controlling infectious source and stopping disease transmission. Key words: Dengue; Disease outbreaks; Epidemiology; Clinical manifestations

Study of gastrointestinal manifestations in Dengue fever

Background: Dengue is an arthropod borne viral haemorrhagic fever. In India between 2015-2017, 790 deaths have been recorded according to NVBDCP data. Gastrointestinal manifestations are among the most common manifestations in dengue fever, and are most often missed due to lack of awareness. This study aims to find the spectrum of Gastrointestinal manifestations and correlation of GI manifestations with severity of Dengue.Methods: A cross-sectional observational study was conducted on 100 consecutive cases of serologically confirmed Dengue fever. Patients were examined clinically, and laboratory data was assessed till they got discharged. Gastrointestinal manifestations of dengue fever were noted and analyzed.Results: This study included 100 consecutive cases of dengue fever. Mean age of the study population was 32.48+12.40 years of them 77 were males and 23 were female patients. Gastrointestinal manifestations were noted in 96% of the patients. GI manifestations noted were Nausea in 71%, Elevation of transaminases in 59%, vomiting in 54%, pain abdomen in 31%, Ascites in 24% hepatomegaly in 14%, diarrhoea in 13%, Acalculous cholecystitis in 13%, Acute fulminant hepatitis in 6%, Upper GI bleed in 6%, splenomegaly in 5%, and Acute pancreatitis in 4% of patients. Of these, GI manifestations like nausea, vomiting, pain abdomen, GI bleed, ascites, jaundice, elevation of transaminases, acute fulminant hepatitis and acute pancreatitis correlated with severity of Dengue fever . Conclusion: Gastrointestinal manifestations in Dengue fever are much more common than once thought of. In our study it was found in 96 percent of patients making it most common manifestations in dengue fever. Transaminitis and Atypical GI manifestations like acute pancreatitis, acute fulminant hepatitis may indicate severe Dengue. The differential diagnosis of an acute febrile syndrome with abdominal pain or gastrointestinal symptoms in patients living in endemic areas should include Dengue fever.

Miller Fisher syndrome developing as a parainfectious manifestation of dengue fever: a case report and review of the literature

BackgroundAlthough dengue viral infections have emerged as one of the most important mosquito-borne diseases, neurological manifestations of dengue infections are uncommon. Guillain–Barré syndrome and Miller Fisher syndrome have been reported to occur as immune-mediated complications following dengue infection. We report the case of a patient who developed Miller Fisher syndrome during the acute phase of dengue fever suggesting that Miller Fisher syndrome may arise as a result of direct neurotropism of the dengue virus.Case presentationA 70-year-old Sri Lankan man with well-controlled diabetes mellitus and hypertension presented with fever of 3 days’ duration, drooping of eyelids, dysarthria, and unsteady gait. He developed bilateral asymmetric partial ptosis, complete external ophthalmoplegia, bilateral palatal palsy, unilateral tongue weakness, ataxia, and areflexia from the second day of illness. He did not have limb weakness. He had evidence of acute dengue infection including progressive thrombocytopenia and leukopenia, positive dengue non-structural protein 1 antigen, dengue immunoglobulin M antibodies, and polymerase chain reaction detection of dengue virus genome in serum. Magnetic resonance imaging of his brain and cerebrospinal fluid analysis were normal. Polymerase chain reaction for dengue virus and immunoglobulin M antibodies in cerebrospinal fluid were negative. Nerve conduction studies showed axonal neuropathy. Antibodies (immunoglobulin G, immunoglobulin M, and immunoglobulin A) against GQ1b and GT1a were negative. He was treated with intravenously administered immunoglobulins and a recommended fluid regimen for dengue fever. He made a complete recovery from dengue fever in 7 days and Miller Fisher syndrome in 20 days.ConclusionsThis case report highlights the rare occurrence of Miller Fisher syndrome during the acute phase of dengue fever. Neurological manifestations may occur as a consequence of direct neurotropism of dengue virus.

Myriad manifestations of dengue fever: Analysis in retrospect

Background: Dengue is a viral disease which has grown dramatically over the years and has emerged as a public health issue requiring intervention to curb its spread. Favorable environment, abundance of vector, and lack of hygiene are leading to unprecedented spread of the disease. Objectives: The objectives were to study the prevalence of various manifestations of dengue fever. Materials and Methods: The study was conducted at Sarojini Naidu Medical College, Agra, during the outbreak from August to November 2015. During the study period, we observed a total of 131 patients. The serology included dengue immunoglobulin (Ig)-M, IgG, and non-structural protein 1 antigen. This study is a hospital-based retrospective study. All the data were expressed in percentage. Results: In this study, we found that cutaneous manifestation was seen in 22.9%, bleeding manifestation in 21.37%, polyserositis in 20.61%, fever in all patients 100%, thrombocytopenia platelet count

Rare magnetic resonance imaging findings in dengue encephalitis

Dengue encephalitis is caused by a nonneurotropic virus of Flaviviridae group. It is a very rare manifestation of dengue fever caused by direct invasion of neural tissue into brain parenchyma. It causes a spectrum of neurologic manifestations such as meningitis, encephalitis, myelitis, and stroke. Here, we discuss a 20-year-old antenatal woman who presented with acute-onset fever and altered sensorium for 1 day. Blood investigations showed mild thrombocytopenia. Magnetic resonance imaging showed characteristic hemorrhagic encephalitis involving bilateral thalami and pons with diffusion restriction. Cerebrospinal fluid for the meningoencephalitic panel was negative. Serology for dengue NS1 antigen and immunoglobulin M antibody were positive. Although considered as a nonneurotropic virus, acute clinical presentation of fever, and altered sensorium apart from herpes and Japanese encephalitis, dengue encephalitis should also be regarded as one of the differentials.

Isolated Lower motor neuron type facial nerve palsy: An unusual manifestation of Dengue haemorragic fever

Dengue is a febrile illness caused by infection with one of four dengue viruses (DENV). It is highly endemic in many tropical countries. Nervous system involvement is seen with serotypes 2 and 3. Neurological manifestations in dengue fever are rare and include encephalopathy, meningitis, acute pure motor weakness, mononeuropathies, transverse myelitis, stroke (both hemorrhagic and ischemic), acute disseminated encephalomyelitis, Guillain Barre Syndrome, hypokalemic paralysis and neuromyelitis optica. Only a few cases of isolated facial nerve palsy in dengue haemorragic fever has been reported.