Dengue haemorrhagic fever: ultrasound as an aid to predict the severity of the disease

Abstract

In a prospective study, the relationship between the clinical severity of dengue haemorrhagic fever (DHF) and the sonographic findings was examined. The study comprised 73 cases classified as mild (grades I-II) and 75 as severe (grades III-IV). Ultrasonography in the mild group revealed pleural effusions in 30%, ascites in 34%, gallbladder wall thickening in 32%, hepatomegaly in 49%, splenomegaly in 16%, and pancreatic enlargement in 14%. In the severe group, pleural effusions, ascites and gallbladder wall thickening were found in 95%, pararenal and perirenal fluid collections in 77%, hepatic and splenic subcapsular fluid collections in 9%, pericardial effusion in 8%, hepatomegaly in 56%, splenomegaly in 16%, and pancreatic gland enlargement in 44%. Ultrasound may be useful for early prediction of the severity of DHF in children.

CLEC5A is critical for dengue virus–induced inflammasome activation in human macrophages

“…43,44 The febrile phase involves high fever, often Ͼ 40°C (104°F), suggesting that DV may induce high amount of endogenous pyrogens (eg, IL-1␤ and TNF-␣) to cause high fever in the victims. However, the underlying molecular mechanism has not been elucidated.…”

“…19 Because hepatosplenomegaly is frequently observed in flaviviral infections, 43,44 and up-regulated GM-CSF and IL-1␤ serum levels correlate with disease severity, 11 GM-M is probably the dominant macrophage subset during flaviviral infection. This argument is supported by the observation that DV-infected M-M did not produce IL-1␤; thus, GM-M seems to play a more important role than M-M in the pathogenesis of DV infection.…”

Evidência de alterações de permeabilidade vascular na dengue: quando a dosagem de albumina sérica define o quadro?

“…Setiawan cols 10 , em 1998, relataram a presença de derrame pleural em 30% de casos de FHD grau I e II (73/148) em crianças de 5 meses a 14 anos 10 e ascite em 23%, 50%, 95% e 90% dos casos grau I, II, III e IV, respectivamente. Na série de casos mostrados aqui, ascite (57%) era mais prevalente do que exsudato pleural (29%).…”

A case of acalculous cholecystitis in the course of dengue fever in a traveller returned from Brazil

“…Usually, the thickness of gallbladder wall in dengue patients exceeds 3 mm in ultrasonography, while thickness exceeding 5 mm indicates a severe course of the disease [23].…”