An Observational Study on Clinical, Epidemiological and Laboratory Profile in Patients of Dengue Fever Admitted to a Tertiary Care Hospital in Kolkata, West Bengal, India in the Year 2016

Abstract

Dengue fever is an important viral hemorrhagic fever amongst the arthropodborne virus illnesses. Dengue suspect patients admitted in the School of Tropical Medicine, Kolkata after being screened for inclusion and exclusion criteria and taken as a case. Objective of the study was to evaluate the detailed clinical picture, laboratory parameters, complications of Dengue fever, its outcome and epidemiological profile. After detailed history, clinical examination and necessary investigations patients were managed according to NVBDCP guidelines. In this study, a total of 103 dengue IgM ELISA positive or Dengue NS1Ag ELISA positive or both patients were included and analyzed. Amongst clinical manifestations most of the patients had myalgia (85.4%), followed by rash (56.3%), vomiting (37.9%) and arthralgia (24.3%). Bleeding manifestations were noted in 37% of patients. 21% of the patients had plasma leakage. Only 13% patients had hypotension which was corrected by only volume replacement in 9% patients. In LFT 85.43% patients showed raised SGOT, 67.86% showed raised SGPT and only minority (1.9%) had raised bilirubin level. SGOT>SGPT were present in 83% patients. In analysis of SGOT elevation 2-5-fold elevation was common (62%). But in analysis of SGPT elevation 2-5-fold elevation and 1-2-fold elevation were comparable. In making a diagnosis 41% cases Dengue IgM was helpful followed by 35% for Dengue NS1Ag and only 1/5th of patients had both tests reactive. Platelet values and days counted from the onset of fever were followed and no specific association was noted. 13.4% of patients had pancreatic involvement and all of them had remarkable/significant lipase elevation than amylase. In our study, some new clinic-biochemical parameters were noted in hepatic, pancreatic involvement, sero-diagnosis, bleeding patterns, platelet count trends and plasma leakage. These should always be kept in mind during an epidemic which would help in managing dengue fever and predicting its outcome.