A profile of dengue cases admitted to a tertiary care hospital in Karnataka, southern India

Background:Acute undifferentiated febrile illness (AUFI) may have similar clinical presentation, and the etiology is varied and region specific.Materials and Methods:This prospective observational study was conducted in a tertiary hospital in South India. All adult patients presenting with AUFI of 3–14 days duration were evaluated for etiology, and the differences in presentation and outcome were analyzed.Results:The study cohort included 1258 patients. A microbiological cause was identified in 82.5% of our patients. Scrub typhus was the most common cause of AUFI (35.9%) followed by dengue (30.6%), malaria (10.4%), enteric fever (3.7%), and leptospirosis (0.6%). Both scrub typhus and dengue fever peaked during the monsoon season and the cooler months, whereas no seasonality was observed with enteric fever and malaria. The mean time to presentation was longer in enteric fever (9.9 [4.7] days) and scrub typhus (8.2 [3.2] days). Bleeding manifestations were seen in 7.7% of patients, mostly associated with dengue (14%), scrub typhus (4.2%), and malaria (4.6%). The requirement of supplemental oxygen, invasive ventilation, and inotropes was higher in scrub typhus, leptospirosis, and malaria. The overall mortality rate was 3.3% and was highest with scrub typhus (4.6%) followed by dengue fever (2.3%). Significant clinical predictors of scrub typhus were breathlessness (odds ratio [OR]: 4.96; 95% confidence interval [CI]: 3.38–7.3), total whole blood cell count >10,000 cells/mm3 (OR: 2.31; 95% CI: 1.64–3.24), serum albumin <3.5 g % (OR: 2.32; 95% CI: 1.68–3.2). Overt bleeding manifestations (OR: 2.98; 95% CI: 1.84–4.84), and a platelet count of <150,000 cells/mm3 (OR: 2.09; 95% CI: 1.47–2.98) were independent predictors of dengue fever.Conclusion:The similarity in clinical presentation and diversity of etiological agents demonstrates the complexity of diagnosis and treatment of AUFI in South India. The etiological profile will be of use in the development of rational guidelines for control and treatment of AUFI.

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“…The mortality with dengue fever in our study (2.3%) is comparable with the mortality rate due to dengue, in recent studies. [2021]…”

Section: Discussionmentioning

confidence: 99%

Acute undifferentiated febrile illness in patients presenting to a Tertiary Care Hospital in South India: clinical spectrum and outcome

Abhilash

Jeevan

Mitra

et al. 2016

J Global Infect Dis

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“…In the study by Kumar et al at Kasturba medical college in 2003, the results found out were similar to this study. 7 The "gold standard "for diagnosis of dengue in a febrile patient is obviously the specific virus detection, virus isolation and virus identification after by cell culture. However, this is gradually being replaced by real time reverse transcriptase polymerase chain reaction (RT-PCR) method for more rapid diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…The clinical basis for diagnosing the patients as having Dengue fever was based on WHO criteria like presentation of febrile illness of 2-7 days duration with features like headache, myalgia, arthralgia, rash and/or haemorrhagic manifestations. 6,7…”

Section: Inclusion Criteriamentioning

confidence: 99%

Diagnosis of dengue fever: roles of different laboratory test methods

2018

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Background: Dengue fever is currently the most important arthropod borne viral disease. Since occurrence of dengue infections has been an epidemic in many parts of India and complications like DHF and DSS are increasing, while at the same time the diagnosis is challenging, particularly the laboratory diagnosis is confusing, this study was conducted to evaluate the different laboratory test methods and to compare their respective efficacy, timing, advantages and disadvantages.Methods: This study was done in the Department of Microbiology in collaboration with the Department of Medicine and Pediatrics in two tertiary care medical colleges and hospitals in eastern India. Blood samples from 319 patients with clinical features suggestive of Dengue fever were included in this study. Laboratory investigations were done which included immunological assays that were performed using commercially available kits - SD dengue duo NS1Ag + Ab combo rapid test, NS1 Ag capture ELISA, IgM capture ELISA, IgG capture ELISA test for dengue and other routine tests -full blood cell count, coagulation tests, routine biochemical and lipid profile were also done. Ethical considerations were taken care of and statistical evaluations were done.Results: An increased detection of IgM antibody (46.15%) was seen in the early febrile period (1-5 days) as compared to the mid-febrile period (6-10 days), and late febrile period (6-10 days) when it is 6.89%. IgG antibody is much less in early febrile period (4.16%). Compared to mid-febrile period (24.13%), and late febrile period (62.5%). IgM antibodies were detected in 44.5% of the samples, IgG antibodies were detected in 43.5% of the samples, Rapid test was positive in 36.9% and NS1AG ELISA was detected in 43.5% of the samples in the study.Conclusions: It can be inferred from our study that for detection of dengue in the early febrile period (1-5 days), estimation of dengue-specific serum IgM is the most sensitive antibody detection method.

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“…antibodies in the patient's blood whereas ELISA is used to differentiate between primary and secondary dengue infections [8]. For rapid diagnosis of the dengue virus, NS1 antigens are detected in the patient's blood [9]. The treatment of the infection is decided on the basis of severity of clinical features and level of fluids in the body.…”

Section: Diagnosis Is Confirmed Upon Detection Of Igm and Iggmentioning

confidence: 99%

Gender and age based evaluation of clinical signs and symptoms of dengue: A secondary data analysis

Momin¹,

Manzoor²,

Mustafa³

et al. 2019

SOJMID

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Background: The global incidence of dengue, a mosquito-borne viral infection, has grown dramatically in recent decades with about half of the world's population is now at risk. Its clinical manifestations include headache, fever, skin rashes, leukopenia and arthralgia. Local data evaluating age and gender based differences in clinical signs and symptoms of dengue are scarce at best. Objective: To compare the clinical signs and symptoms of dengue across gender and age based groups. Methods: A secondary data analysis of a randomized controlled trial on the effects of silymarin on hepatic enzymes and clinical manifestation of dengue was conducted. The clinical signs and symptoms of the dengue patients were recorded at the baseline before giving trial intervention. Chisquare test was used to make desired comparisons across gender and age based groups whereas the significance level was set at 0.05. Results: The study results showed that rash (p=0.047) and infected conjunctiva (p=0.013) were significantly associated with gender of the patients whereas nausea and vomiting (p=0.01), headache (p=0.016), retro-orbital pain (p=0.049) and infected conjunctiva (p=0.032) were significantly associated with age of the patients. Conclusion: A significant association of rash and injected conjunctiva with gender of dengue patients and of nausea and vomiting, headache, retro-orbital pain and injected conjunctiva with age of dengue patients was found. Further evaluation of study findings because of their potential implications for the symptomatic management of dengue patients is recommended.

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A profile of dengue cases admitted to a tertiary care hospital in Karnataka, southern India

Cited by 12 publications

References 3 publications

Acute undifferentiated febrile illness in patients presenting to a Tertiary Care Hospital in South India: clinical spectrum and outcome

Acute undifferentiated febrile illness in patients presenting to a Tertiary Care Hospital in South India: clinical spectrum and outcome

Diagnosis of dengue fever: roles of different laboratory test methods

Gender and age based evaluation of clinical signs and symptoms of dengue: A secondary data analysis

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