Dengue: A Clinicopathological Correlation

Dengue fever is an acute febrile disease in the tropical and subtropical areas and today is being acknowledged as one of the worlds major emerging infectious disease. In the last 50 years, incidence has increased 30 folds. An estimated 2.5 billion live in over 100 endemic countries and areas were dengue can be transmitted. Up to 50 million infections occur annually with 500000 cases of dengue hemorrhagic fever and 22000 deaths in children with wide spectrum of clinical features (1). Hence the study was undertaken to study the clinical features in dengue patients. Aims and Objectives The study is undertaken to study the clinical spectrum of dengue fever and to co relate various haematological and biochemical parameters with severity of dengue. Materials and methods A prospective observational hospital based study carried out in Mahatma Gandhi Memorial Hospital, Kamothe, Mumbai over a period of two years in 100 IPD and OPD patients with fever who were investigated and found to be either Ns1 antigen Positive or IgM antibody positive or both positive, for dengue. Patients diagnosed With malaria, typhoid and leptospirosis or any other illness after admission or aged less than 12 years were excluded from study. The relationship of occurences of various clinical manifestations and complications as well as their relationship to gender and age group were analyzed in the study. Result The most common symptom seen in patients with dengue was Fever followed by headache. Hemorrhagic manifestations were significantly more common in patients with Dengue Hemorrhagic Fever (DHF) than Dengue fever. Thrombocytopenia is common in both Dengue fever (DF) and DHF which correlated well with clinical incidence of plasma leakage like hypoalbuminemia & haemoconcentration. Most of the patients with DF were managed with intravenous crystalloids. Patients with DHF, who needed platlet transfusions were given platelet transfusions, for the correction of thrombocytopenia, haemoconcentration or bleeding tendency than DF patients. Conclusion The two fundamental pathological attributes in DHF were plasma leakage and intrinsic coagulopathy, and they where more severe in DHF as compared to DF. Appropriate interventions with judicious fluid therapy and platelets could offset adverse outcomes and ensure a favourable outcome.