Clinical Spectrum of Dengue Fever: A Single Center Study

Abstract

Objectives: To assess the clinical features, diagnostic modalities and clinical outcomes in patients of dengue fever and dengue hemorrhagic fever to guide clinician for an early diagnosis and effective treatment.

Methods: A single-centered retrospective cross-sectional study which included 150 patient of confirmed dengue fever admitted at Northwest General Hospital, Peshawar, Pakistan in the year 2017.

Results: Our study showed that the incidence of dengue fever was more common in male patients. Blood counts show that thrombocytopenia and leukopenia are common in such patients. NS1 (dengue antigen) and IgM when tested were positive in 100% and 48.6% of the patients. Out of total 6.6% of the patients progressed to DHF. Diagnostic clinical features are myalgia (most common), orbital pain, anorexia in dengue fever while vomiting, diarrhea and rash were more common in DHF. In addition, 22.7% of the patients presented with bleeding manifestation, gum bleed (most common), Petechiae, epistaxis and hematuria. Only 2 patients developed acute kidney injury. Among total 10% of the patients also developed plasma leakage syndrome. Mean hospital stay was higher for patients who developed DHF.

Conclusion: Dengue fever incidence is greater in males. Thrombocytopenia and leucopenia are associated with the disease. Bleeding tendency increases with severe thrombocytopenia. Myalgia is the common symptoms and rash the least common. Vomiting, diarrhea and rash is more common in DHF patients.  Peri-orbital puffiness was a relatively newer finding in patients suffering from this disease. NS1 dengue antigen and IgM dengue antibodies testing when combined has a higher diagnostic sensitivity. Hospital stay is lengthened by higher drops in platelet counts, bleeding tendency, renal failure and with the development of plasma leakage syndrome