”Honeycomb” pattern of gallbladder wall thickening – A forward step in early diagnosis of “Severe Dengue Fever”

Parmar, Jitendra; Vora, Maulik; Mohan, C. Raja; Shah, Sandip; Mahajan, Harsh; Patel, Tapan

doi:10.4103/ijri.ijri_363_18

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…Findings in the gallbladder wall as either thickening (> 3 mm) or abnormal appearance (e.g., striated, thickened, contracted, and “honeycomb” pattern) are not specific since they can be seen in several diseases, such as cholecystitis, congestive heart failure, renal failure, liver disease, and pancreatitis [ 25 ]. However, when restricted to dengue patients, they have been found to be potentially useful to diagnose or predict dengue with warning signs or severe dengue [ 26 – 29 ]. This was confirmed in our study since abnormal appearance of the gallbladder wall (pericholecystic liquid) was associated with dengue with warning signs.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of remote radiologist-interpreted point-of-care ultrasound for suspected dengue patients in a primary health care facility in Colombia

Osorio,

Prieto,

Zuluaga

et al. 2023

Infect Dis Poverty

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Background Early identification of plasma leakage may guide treatment decisions in dengue patients. This study evaluated the value of point-of-care ultrasound (POCUS) to detect plasma leakage and predict hospitalization or referral to a higher level of care in suspected dengue patients under routine conditions at a primary care facility in Colombia. Methods We conducted a cohort study between April 2019 and March 2020 in a primary care hospital in Cali, Colombia. We prospectively included and followed 178 patients who were at least 2 years old with fever of less than 10 days and clinician-suspected dengue. A trained general practitioner performed a standardized POCUS protocol. Images were quality-rated and overread by an expert radiologist, and her results and those of the general practitioner were compared using the Kappa index. Logistic regression was used to identify factors associated with plasma leakage at enrollment and explore its prognostic value regarding hospital admission or referral to a higher level of care. Results Half (49.6%) POCUS images were of suitable quality to be interpreted. The proportion of plasma leakage reported by the radiologist was 85.1% (95% CI: 78.6–90.2%) and 47.2% by the study physician (Kappa = 0.25, 95% CI: 0.15–0.35). The most frequent ultrasound findings were ascites (hepatorenal 87.2%, splenorenal 64%, or pelvic 21.8%) and gallbladder wall thickening (10.5%). Plasma leakage was higher in subjects with thrombocytopenia (aOR = 4, 95% CI: 1.3–12.1) and lower in patients 30–59 years old (aOR = 0.1, 95% CI: 0.0–0.4) than in those 18 years old or younger. POCUS evidence of plasma leakage (aOR = 8.2, 95% CI: 2.2–29.9), thrombocytopenia (aOR = 6.3, 95% CI: 2.4–16.0) and pulse pressure (aOR = 1.1, 95% CI: 1.07–1.2) were associated with hospital admission or referral to a higher level of care. Conclusions Ultrasound is useful to detect plasma leakage in primary care and, challenges remain to guarantee high-quality images and diagnostic accuracy, for which a standardized dengue POCUS protocol and training program is needed. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Evaluation of remote radiologist-interpreted point-of-care ultrasound for suspected dengue patients in a primary health care facility in Colombia

Osorio,

Prieto,

Zuluaga

et al. 2023

Infect Dis Poverty

View full text Add to dashboard Cite

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Ecografía en dengue: 10 hallazgos claves

Galindo Dávila,

Gomez Sandoval,

Ardila Gómez

et al. 2024

Acta Colombiana de Cuidado Intensivo

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Admission ultrasonography as a predictive tool for thrombocytopenia and disease severity in dengue infection

Donaldson

Mel

Clarice

et al. 2021

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Ultrasound (US) is an investigation available in many acute care settings. Thrombocytopenia is a well-described complication of dengue infection and has been shown to correlate with disease severity. The purpose of this study was to assess the utility of admission ultrasonography in predicting thrombocytopenia and disease severity in patients infected with dengue virus. Methods Data were collected prospectively on 176 patients (male, n=86; female, n=90) admitted to the Nawaloka Hospital, Sri Lanka with dengue infection between December 2016 and August 2018. All patients had an US scan on admission and disease severity was determined using the World Health Organization 2009 classification. Results There were 106 (60.2%) cases of dengue with/without warning signs and 70 (39.8%) cases of severe dengue. Patients with an abnormal US on admission were more likely to have severe dengue. Gallbladder wall thickening was the most common US abnormality. Abnormal US findings significantly correlated with more pronounced thrombocytopenia from day 2 of admission. Conclusions An abnormal US scan on admission can aid in identification of patients at risk of developing severe dengue and can be used as a novel clinical tool to identify patients at risk of severe thrombocytopenia.

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”Honeycomb” pattern of gallbladder wall thickening – A forward step in early diagnosis of “Severe Dengue Fever”

Cited by 5 publications

References 13 publications

Evaluation of remote radiologist-interpreted point-of-care ultrasound for suspected dengue patients in a primary health care facility in Colombia

Evaluation of remote radiologist-interpreted point-of-care ultrasound for suspected dengue patients in a primary health care facility in Colombia

Ecografía en dengue: 10 hallazgos claves

Admission ultrasonography as a predictive tool for thrombocytopenia and disease severity in dengue infection

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