Ultrasound as an Aid to Diagnosis in Dengue

Abstract

Objective: To determine the ultrasound findings in patients with dengue fever and to evaluate their relationship with laboratory parameters. Study Design and Setting: This prospective cross-sectional study was conducted at –removed for blind review---from September 2020 to August 2021. Methodology: Total of 248 patients diagnosed with dengue fever, fulfilling the exclusion and inclusion criteria, were included in the study. Demographic data was recorded on a structured proforma. Serological confirmation along with complete blood counts and liver function tests were obtained. Abdominal and chest ultrasounds were conducted in all patients. The ultrasonographic features of these patients were analyzed with laboratory investigations through SPSS version 23. Student’s t-test and Chi-square tests were used assessingess the association between the ultrasonographic findings and laboratory features. A P-value of <0.05 was considered significant. Results: The most common ultrasonographic feature among dengue patients was acalculous cholecystitis (49.6%) followed by hepatomegaly (47.2%), splenomegaly (46.8%), altered echotexture of the liver (46.4%), ascites (37.5%) and pleural effusion (7.3%). Acalculous cholecystitis and ascites were significantly associated with severe thrombocytopenia and increasing hematocrit. Acalculous cholecystitis, ascites, pleural effusion and altered echotexture of the liver were associated with raised transaminases. A low platelet count showed the strongest relationship with sonographic features of capillary leak syndrome. Conclusion: Ultrasound is a useful investigation to diagnose severe, critical dengue. The development of ultrasonographic features should prompt proactive management of these patients in order to prevent emergence of severe complicated dengue.