Dr. Dinesh N*, Dr. V.D.Patil, M.D.D.C.H.**, Dr. N.S.Mahantshetti, M.D.***
Dept. of Pediatrics, JNMC, Belgaum*, Dept. of Pediatrics, JNMC, Belgaum**, Dept. of Pediatrics, JNMC, Belgaum ***
Severe dengue infections can give rise to unusual manifestations such as myocarditis, encephalitis, acute fulminant hepatic failure, and persistent thrombocytopenia. Although these manifestations are rare, in recent years they have been reported with increased frequency. They tend to occur in younger age group and have a high mortality.
Aims and Objectives
To study unusual manifestations and their significance in dengue fever.
Subjects & Methods
61 serologically confirmed cases of dengue fever reported at KLES Hospital attached to J. N. Medical College, Belgaum between August 2001 to 2005 were retrospectively studied for unusual manifestations.
85 children were clinically suspected to be suffering from dengue fever. Out of 61 serologically confirmed cases, 16 had unusual manifestations (26%) 9 were classified as DHF. 3 where DSS. 3 were DFB and one was DF. 11 cases (68.75%) were considered as secondary infection and 5 cases (31.25%) were primary. Mean age of presentation was 5 years. 9 were males and 7 females.
Dengue myocarditis - 07 • Dengue encephalopathy - 01 • Dengue encephalitis - 02 • Intracranial bleed - 02 • Acute fulminant hepatic failure - 02 • Persistent thrombocytopenia (more than 10 days) - 02.
Mortality rate was high (36%) among those who presented with unusual manifestations. Prolonged shock, metabolic acidosis hyponatremia and DIC were associated with poor prognosis
Dengue fever can present with variety of unusual manifestations. They tend to occur in younger age group and had high mortality. In endemic areas, dengue should be considered in children who present with clinical features of myocarditis, encephalitis, encephalopathy, fulminant hepatic failure and persistent thrombocytopenia.
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