Presence of Warning Signs in Dengue Fever as the predictors of Progression to Severe Disease
AbstractObjective: To assess the prevalence of different Warning Signs, hematological and biochemical abnormalities in patients hospitalized with dengue fever and to assess the Presence of Warning Signs in Dengue Fever as the predictors of Progression to Severe Disease.
MethodsThe study included those patients who had clinical evidence of the presence of some of the warning signs of dengue fever during primary evaluation either in the Emergency of Outpatient departments. The confirmation of diagnosis was based upon further clinical and serological evaluation (NS1Ag, IgM and IgG antibody titers). A study Performa was used to document the history and warning signs of dengue fever. All patients had complete hematological and relevant biochemical profiles during hospital stay. The prevalence of different warning signs was documented and their association with deterioration into severe disease was assessed.
Results A total of 100 patients who had the confirmed diagnosis of dengue fever were included in the study. The fever, associated with chills and rigors was the most common symptom and mode of presentation. There was clinical evidence of dehydration in 30% and capillary refill was decreased in 70% of patients. The history of abdominal pain and vomiting was present in 31% and 19% of patients respectively. There was subjective feelings of weakness and lethargy in 35%, while 2% patients had a positive torniquet test. The clinical evidence of mucosal and gross bleeding was present in 8% of cases and 2% had capillary leakage and developed ascites and pleural effusions. The correlation of the presence of warning signs leading to severe disease was statistically not significant in the study.
Conclusion Severe Dengue fever developed in 8% of cases, but the correlation of the presence of warning signs and deterioration to severe disease was statistically not significant in the study.
Keywords:Dengue Fever, Severe dengue fever, Dengue hemorrhagic fever
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