Honey Comb Sign- An early predictor for diagnosis of Dengue Fever

Dr. Falguni Parakh; Dr. Dharita S. Shah

Volume : VII, Issue : XII, December - 2018

Honey Comb Sign- An early predictor for diagnosis of Dengue Fever

Dr. Falguni Parakh, Dr. Dharita S. Shah

Abstract :

Aim: To evaluate the usefulness of ultrasonographic finding of edematous GB wall (Honeycomb pattern) in early diagnosis of dengue fever.

Methods and material: A prospective observational study was performed in 100 patients with clinically suspected Dengue Fever, having high–grade fever and abdominal pain. Immediate abdominal USG was performed in all the patients and findings were recorded. A specific change – “Honeycomb” pattern in the thickened gallbladder (GB) wall (mostly in the fundal area) – on USG suggested the diagnosis of Dengue Fever, which was subsequently confirmed by serology in all patients. Associated USG findings like pleural effusion, ascites and splenomegaly were also looked for. The obtained data was summarized into tables and charts, and analysed. Subsequent USG were performed on fourth and seventh day.

Statistical analysis used: prospective observational study was performed and inferential statistics were obtained from the data using chi–square test.

Results: Out of 100 patients in the study, 86 patients had edematous wall of Gall Bladder with the specific “Honeycomb” pattern. Out of 100, 92 patients confirmed to have dengue fever, as confirmed after USG by platelet count and serologic tests, four patients tested positive for viral hepatitis markers and in four patients no definite cause was identified. USG features of Dengue Fever included a thickened GB wall in 84 patients (91.3%), ascites in 76 patients (82.6%), splenomegaly in 40 patients (43.5%), and pleural effusion in 70 patients (76.1%). Reduction in GB wall thickening was noted in clinically improving patients.

Conclusions: Early Abdominal USG in patients with clinically suspected Dengue Haemorrhagic Fever can be used as a first–line imaging modality to detect early ultrasonographic signs that are suggestive of the disease prior to obtaining serologic confirmation test results, especially in a dengue fever endemic area.