Original Research Article
Year: 2019 | Month: August | Volume: 6 | Issue: 8 | Pages: 457-467
The Dreadful Dengue - A Complete Clinical Chemical Complication Comparison
Dr. Venkata Tulasi Ramesh Potluri1, Dr. Santhosh Kumar Arepalli2, Dr. Eswar Ganti3, Dr. Anjaneya Prasad Velivala4, Dr. Lakshmi Spandana Potluri5
1Associate Professor of Pediatrics, 2Assistant Professor of General Medicine, 3Professor Emeritus of General Medicine, 4Professor and Head of Department Of General Medicine, 5Post Graduate Student in Department Of General Medicine,
Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Gannavaram, Andhra Pradesh
Corresponding Author: Dr. Lakshmi Spandana Potluri
ABSTRACT
Background: Dengue infection results from four dengue virus serotypes (DEN-1,2,3,4) of Flavivirus genus. It is the most common arboviral infection with half the world's population at risk every year. Recovery from infection by one serotype provides lifelong immunity against that serotype. In the absence of an effective antiviral agent, the treatment mainly relies on judicious fluid replacement.
Materials and methods: This is a hospital based descriptive study with 200 patients of confirmed dengue fever admitted from March 2017 to Feb 2018 and 200 from March 2018- Feb 2019. Detailed history was taken. CBP, LFT,RFT, chest xray, cardiac evaluation and ultrasound was done.NS1Ag, IgM and IgG dengue antibodies were estimated using Rapid strip test. The diagnosis of dengue fever, dengue hemorrhagic fever and dengue shock syndrome was based on WHO criteria.
Results: Amongst the clinical manifestations, fever was the constant symptom. There was a decrease in number of patients presenting with headache(p-0.001) and myalgias(p-0.561) while there was a significant increase in the number of patients presenting with conjunctival congestion (p-0.081), vomiting(p-0.001), rash(p-0.012), pain abdomen(p-0.041), bleeding manifestations (p<0.0001). There was an increased derangement lab parameters – hemoconcentration (p-625), leukopenia(p-0.0001), thrombocytopenia(p-0.0001), hyperbilirubinemia (p-0.06), deranged RFT(p-0.312) and liver enzymes (evaluated in categories 2-4 fold, 5-10fold, >10fold increase) SGOT(p-0.004), SGPT(p-0.002) in the present year when compared to the previous year. Evaluation of the complications showed a decrease of hypotension, while there was an increase in serositis, AKI, ARDS, DSS and hematoma formation. There were 3 cases of dengue myocarditis in 2018-19 while there were none in 2017-18. There were no fatalities in 2017-18 while there were 3 mortalities in 2018-19
Conclusion: The sudden morbid increase in the number of patients presenting with hepatopathy which could be attributed to infection with a newer serotype of Dengue virus in a previously infected patient. In the absence of an effective antiviral agent against dengue, the need for early detection management is essential to combat complications like hepatopathy and myocarditis which may prove to be fatal.
Key words: Dengue, Hepatopathy, Myocarditis, Clinical Study, Dengue Shock Syndrome, Dengue Haemorrhagic Fever, Viral Fever
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