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CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(01): 078-083
DOI: 10.1055/s-0042-1751320
Original Article

Look Out for Fever: Clinical Profile of Dengue in Young Adults in a Tertiary Care Center in North India

Gursheen Kaur
1   Department of Cardiology, Oswal Cancer Hospital, Ludhiana, Punjab, India
,
Vipin Kumar
2   Department of General Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
,
Sandeep Puri
2   Department of General Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
,
Ruchita Tyagi
3   Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
,
Ashwajit Singh
4   Department of Skin, JSS Medical College, Mysore, Karnataka, India
,
Harpreet Kaur
3   Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
› Author Affiliations Funding None.
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Abstract

Background Dengue fever (DF) is a common viral disease, clinical manifestations of which vary from influenza-like illness (DF) to life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The aim of this article was to study the clinical profile of DF in young adults.

Material and Methods This was an observational study conducted in the department of medicine over a period of 2 years (January 1, 2013—December 31, 2014). Patients aged between 18 and 30 years with serology proven (nonstructural protein 1 [NS1]/dengue immunoglobulin M [IgM]) DF were included in this study. The clinical and laboratory data was recorded and analyzed.

Results Out of 418 cases, the incidence of DF, DHF, and DSS was 87.32, 7.66, and 5.02%, respectively. The most common presentations were fever (99.76%) followed by vomiting (29.43%), pain abdomen (17.94%), myalgias (13.16%), petechial rash (12.92%), and bleeding (10.29%). Dengue NS1 and IgM antibodies were positive in 87.3% and 88.12% of the patients, respectively. Ascites, splenomegaly, hepatomegaly, pleural effusion, gall bladder wall edema, and pericardial effusion were present in 8.13, 6.94, 6.70, 5.98, 2.63, and 0.72% of the patients, respectively. Complications included bleeding (10.29%), acute respiratory distress syndrome (1.67%), myocarditis (1.44%), seizures (1.44%), hemarthrosis (0.24%), and encephalopathy (0.24%). The mortality rate was 3.35% with death of 14 patients. Shock, bleeding, and elevated serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase levels predicted adverse outcome.

Conclusion DF can present with a plethora of clinical manifestations in endemic areas. Adverse outcome is more likely if patients have elevated SGOT levels, shock, and bleeding. Continuous seroepidemiological surveillance is essential to control outbreak and minimize morbidity and mortality.

Keywords

dengue - SGOT - SGPT


Publication History

Article published online:
17 August 2022

© 2022. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Rigau-Pérez JG, Clark GG, Gubler DJ, Reiter P, Sanders EJ, Vorndam AV. Dengue and dengue haemorrhagic fever. Lancet 1998; 352 (9132): 971-977
    Google Scholar
  • 2 Stephenson JR. Understanding dengue pathogenesis: implications for vaccine design. Bull World Health Organ 2005; 83 (04) 308-314
    PubMedGoogle Scholar
  • 3 Jelinek T. Dengue fever in international travelers. Clin Infect Dis 2000; 31 (01) 144-147
    CrossrefPubMedGoogle Scholar
  • 4 Gunasekaran P, Kaveri K, Mohana S. et al. Dengue disease status in Chennai (2006-2008): a retrospective analysis. Indian J Med Res 2011; 133: 322-325
    PubMedGoogle Scholar
  • 5 Zainab Ghazala, Anuradha HV, Shivamurthy MC. Pattern of management and outcome of dengue fever in pediatric in-patients in a tertiary care hospital: a prospective observational study. Int J Basic Clin Pharmacol 2014; 3: 534-538
    CrossrefGoogle Scholar
  • 6 Sharma SK, Ahluwalia G. Dengue fever in India: an overview. Medicine Update. 2010; 20: 657-659
    Google Scholar
  • 7 Kumar A, Rao CR, Pandit V, Shetty S, Bammigatti C, Samarasinghe CM. Clinical manifestations and trend of dengue cases admitted in a tertiary care hospital, Udupi district, Karnataka. Indian J Community Med 2010; 35 (03) 386-390
    PubMedGoogle Scholar
  • 8 Centers for disease Control and Prevention. . Dengue Branch (Feb 2 & June 5, 2005) Accessed June 13, 2022 at http://www.cdc.gove/ncidod/EID/vol9no4/02–0267
  • 9 Reinert JF, Harbach RE, Kitching IJ. Phylogeny and classification of Aedini (Diptera: Culicidae), based on morphological characters of all life stages. Zool J Linn Soc 2004; 142: 289-368
    CrossrefGoogle Scholar
  • 10 WHO. (2009) Dengue Guidelines for Diagnosis, Treatment, Prevention and Control WHO (2009). Accessed June 13, 2022 at: http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf
    Google Scholar
  • 11 Kashinkunti, Shiddappa, Dhananjaya M. A study of clinical profile of dengue fever in a tertiary care teaching hospital. Sch J Appl Med Sci 2013; 1: 280-282
    Google Scholar
  • 12 Avarebeel S, Prahlad KA, Tabassum L. Study of clinical and demographic profile of dengue fever. J Evidence Based Med Healthcare 2014; 1: 211-230
    CrossrefGoogle Scholar
  • 13 Kauser MM, Kalavathi GP, Radadiya M. et al. A Study of Clinical and laboratory profile of dengue fever in tertiary care hospital in central Karnataka, India. Global J Med Res: B Pharma, Drug Discovery. Toxicology Med 2014; 14: 7-12
    Google Scholar
  • 14 Imam A, Prashanth ED. Clinical profile of dengue infection at a center in north Karnataka, India. Glob J Infect Dis Clin Res 2019; 5: 6-9
    CrossrefGoogle Scholar
  • 15 Tsai JJ, Chan KS, Chang JS. et al. Effect of serotypes on clinical manifestations of dengue fever in adults. J Microbiol Immunol Infect 2009; 42 (06) 471-478
    PubMedGoogle Scholar
  • 16 Fujimoto DE, Koifman S. Clinical and laboratory characteristics of patients with dengue hemorrhagic fever manifestations and their transfusion profile. Rev Bras Hematol Hemoter 2014; 36 (02) 115-120
    CrossrefPubMedGoogle Scholar
  • 17 Patil AA. Clinico laboratory profile of suspected dengue patients in a tertiary care hospital. MedPulse – Int Med J 2015; 2: 54-57
    Google Scholar
  • 18 Lo CH, Ben RJ, Chen CD, Hsueh CW, Feng NH. Clinical experience of dengue fever in a regional teaching hospital in southern Taiwan. J Intern Med Taiwan 2009; 20: 248-254
    Google Scholar
  • 19 Mandal SK, Ganguly J, Sil K. et al. Clinical profile of dengue fever in a teaching hospital of Eastern India. Natl J Med Res 2013; 3: 173-176
    Google Scholar
  • 20 Jayadas TTP, Kumanan T, Arasaratnam V, Gajapathy K, Surendran SN. The clinical profile, hematological parameters and liver transaminases of dengue NS1 Ag positive patients admitted to Jaffna Teaching Hospital, Sri Lanka. BMC Res Notes 2019; 12 (01) 604
    CrossrefPubMedGoogle Scholar
  • 21 Padyana M, Karanth S, Vaidya S, Gopaldas JA. Clinical profile and outcome of dengue fever in multidisciplinary intensive care unit of a tertiary level hospital in India. Indian J Crit Care Med 2019; 23 (06) 270-273
    CrossrefPubMedGoogle Scholar
  • 22 Itoda I, Masuda G, Suganuma A. et al. Clinical features of 62 imported cases of dengue fever in Japan. Am J Trop Med Hyg 2006; 75 (03) 470-474
    CrossrefPubMedGoogle Scholar
  • 23 Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Dev Ctries 2012; 6 (07) 551-554
    CrossrefPubMedGoogle Scholar
  • 24 Rahim MA, Sikder MS. Clinicopathologic manifestations and outcome of dengue fever and dengue haemorrhagic fever. Bangladesh Med Res Counc Bull 2005; 31 (01) 36-45
    PubMedGoogle Scholar
  • 25 Horvath R, McBride WJH, Hanna J. Clinical features of hospitalized patients during dengue-3 epidemic in Far North Queensland, 1997–1999. Dengue Bull 1999; 23: 24-29
    Google Scholar
  • 26 Sharma S, Sharma SK. Clinical profile of DHF in adults during 1996 outbreak in Delhi, India. Dengue Bull 1998; 22: 20-27
    Google Scholar
  • 27 Daniel R, , Rajamohanan, Philip AZ. A study of clinical profile of dengue fever in Kollam, Kerala, India. Dengue Bull 2005; 29: 197-202
    Google Scholar
  • 28 Seema A, Singh V, Kumar S, Kumar A, Dutta S. The changing clinical spectrum of dengue fever in the 2009 epidemic in North India: a tertiary teaching hospital based study. J Clin Diagn Res 2012; 6: 999-1002
    Google Scholar
  • 29 Bhushan D, Kumar R. Clinical profile, hepatic dysfunctions, and outcome of dengue patients in a tertiary care hospital of Eastern India. J Assoc Physicians India 2018; 66 (03) 52-54
    PubMedGoogle Scholar
  • 30 Méndez A, González G. [Abnormal clinical manifestations of dengue hemorrhagic fever in children]. Biomedica 2006; 26 (01) 61-70
    PubMedGoogle Scholar
  • 31 Manohar B, Kumar BS, Prasanna L, Dudala SR, Kumar CN, Sailaja A. Clinical and microbiological profile of acute dengue infection in teaching hospital. Indian J Basic Appl Med Res 2015; 4: 401-408
    Google Scholar
  • 32 Bhaskar ME, Moorthy S, Kumar NS, Arthur P. Dengue haemorrhagic fever among adults–an observational study in Chennai, south India. Indian J Med Res 2010; 132: 738-740
    PubMedGoogle Scholar
  • 33 Kamath SR, Ranjit S. Clinical features, complications and atypical manifestations of children with severe forms of dengue hemorrhagic fever in South India. Indian J Pediatr 2006; 73 (10) 889-895
    CrossrefPubMedGoogle Scholar
  • 34 Kumar A, Rao CR, Pandit V, Shetty S, Bammigatti C, Samarasinghe CM. Clinical manifestations and trend of dengue cases admitted in a tertiary care hospital, Udupi district, Karnataka. Indian J Community Med 2010; 35 (03) 386-390
    CrossrefPubMedGoogle Scholar
  • 35 Jain A, Shah AN, Patel P. et al. A clinico-hematological profile of Dengue outbreak among healthcare professionals in a tertiary care hospital of Ahmedabad with analysis on economic impact. Natl J Community Med 2013; 4: 286-290
    Google Scholar