Clinical profile and outcome of children admitted with dengue fever in a tertiary care hospital in South India

Abstract

Objective: The objective is to study the clinical profile and outcome of patients admitted with dengue fever and to identify the risk factors for severe dengue (SD). Materials and Methods: This is a descriptive study of children admitted with a diagnosis of dengue fever from January 2013 to June 2014 in a tertiary care Medical College Hospital in South India. Results: A total of 306 children were admitted with dengue fever during the study period with a mean age of 7.8±3.2 years and male:female ratio of 1.06:1. The most common symptoms apart from fever were vomiting (54.9%) and abdominal pain (36.3%). Tender hepatomegaly and narrow pulse pressure were the most common signs. 131 (42.8%) were classified as dengue fever without warning signs, 119 (38.8%) as dengue fever with warning signs (DWS), and 56 (18.4%) as severe dengue (SD) according to the WHO guidelines 2012. A significant difference in aspartate aminotransferase’ and alanine aminotransferase elevation was noted among dengue fever without warning signs, DWS, and SD. Hemoconcentration, thrombocytopenia, hypoproteinemia, hypoalbuminemia, hypocalcemia, hypoglycemia, hypokalemia, hepatic derangement, elevated urea, and creatinine were significantly associated with SD. The mean values of prothrombin time, international normalized ratio, and activated partial thromboplastin time in SD were 19±3.7 s, 1.5±0.3 s, and 46±7 s, respectively. The finding of thalamic hypodensity in one patient with dengue encephalopathy was only rarely described in literature. Conclusion: Bleeding manifestations altered coagulation profile as well as deranged liver functions can be used as predictors of severe dengue fever.