A study of clinical and laboratory profile of dengue fever at a tertiary care hospital in Kerala

Padmakumar Balasundaram; Poornima Karakkandy Nanu; Kurukkanparambil Sreedharan Mohanan; Sherief Sulaiman

Volume : VII, Issue : III, March - 2018

A study of clinical and laboratory profile of dengue fever at a tertiary care hospital in Kerala

Padmakumar Balasundaram, Poornima Karakkandy Nanu, Kurukkanparambil Sreedharan Mohanan, Sherief Sulaiman

Abstract :

Introduction

Dengue is hyperendemic in India, with the rampant spread of the infection attributed to rapid urbanization, lifestyle changes, poor hygienic practices, unauthorized dwelling, improper water storage, etc. Dengue infection presents with various symptoms and signs. The exact clinical profile is important for patient management and thus is crucial for saving lives. The present study is an attempt to describe the salient clinical and laboratory findings of serologically confirmed hospitalised cases of dengue fever during the study period.

Methods

Patients admitted with undifferentiated short feile illness (<7 days duration), at medical college hospital, Alappuzha, Kerala, between June 2013 and December 2013 were included. Patients with a definite alternative diagnosis like typhoid, malaria, UTI, respiratory infection were excluded. Socio demographic and clinical details were collected using a predesigned proforma. A detailed clinical examination was performed and relevant laboratory investigations were done. Occupational history, history of contact with animals / contaminated water were elicited. IgM ELISA test for Leptospirosis and Dengue (Mac ELISA) were done for all patients on the 7th day of fever. The various symptoms, physical and laboratory findings were compared between dengue fever and other common feile illnesses. Statistical analysis was done using SPSS–16e

Results

Fever was the most common presenting symptom. The various symptomatology include abdominal pain (23.9%), arthralgia (21.7%), catarrhal symptoms (19.6%), nausea (15.2%), diarrhea (10.9%), dyspnea (8.7%), cough (6.5%). The frequency of physical findings were

skin rashes (87%), tachypnea (32.6%), muscle tenderness (13%), conjunctival congestion (11%),

hepatomegaly (10.9%), pallor (8.7%). The altered laboratory parameters include thrombocytopenia (95.7%), elevated SGOT (80.4%), leucopenia (58.7%), elevated SGPT (69.6%), elevated ALP (67.4%), hypoalbuminemia (30.4%), anemia (19.6%), elevated creatinine (15.2%), elevated blood urea (10.9%), hyperbilirubinemia (8.7%), leukocytosis (4.3%).

conclusion

Patients with dengue fever present with varying manifestations. The symptomatology overlap with those of other common feile illness. Arthralgia, muscle tenderness, lecopenia and thrombocytopenia are significantly more common in dengue than other feile illnesses. A high index of suspicion in at–risk population helps in early diagnosis and management.