Clinical profile of dengue fever in tertiary hospital, Nellore

Objective: Dengue viral infections are among the most important mosquito borne diseases of the Indian subcontinent and have become a major global public health concern. The objective was to study the clinical, biochemical profile and complications of dengue fever. Methodology: This prospective study was conducted in the Department of General Medicine at Narayana Medical College & Hospital, Nellore during the recent epidemic of Dengue fever in Andhra Pradesh from September – December 2015. All the patients who were suspicious cases of Dengue fever and who fulfilled were included in the study. Results: Of the 366patients admitted with probable dengue fever, 170 patients were serologically confirmed as dengue fever. Of these 170 cases, most of the cases were male (54.7%), and the most common age group was 21-30 years. The most common presentation was fever in 170 (100%), followed by vomitings (44.7%), myalgia (30.5%), abdominal pain (28.8%) and headache (25.8%).Most common hemorrhagic manifestation was malena (9.4%). On examination hepatomegaly in 45 patients (26.5%) and splenomegaly (15.3%) were observed. NS1 Ag positive in 141 patients(82.9%), IgM positive in 22 patients (12.9%) and IgG positive in 7 patients (4.1%) by Immunochromatographic test (J. Mitra, India). Leucopenia was seen in majority (71.7%) of the patients. Elevated hematocrit was seen in 48 patients (28.2%), AST in13 patients (7.6%), ALT in 22 patients (12.9%) and creatinine in 33 patients (19.4%). Thrombocytopenia was the single most common hematological abnormality noted in 149patients (87.6%). Radiologically GB wall distention (56.4%), hepatomegaly (26.5%) and Ascites (18.2%)was observed. Dengue Fever was present in 133(66.7%), DHF in 42 (24.7%) and DSS in 15 (8.6%).Out of 170 patients most of them had, acute kidney injury (19.4%), hepatitis (16.5%), ARDS(4.5%) and multi organ dysfunction in 7 patients (4.1%), pancreatitis (2.35%) and bell’s palsy in two patients Conclusion: Fever, vomiting and malaise are the common manifestations. They should prompt a clinician on the possibility of dengue infection. Awareness and timely recognition of the atypical & hemorrhagic manifestations are very important for proper management especially in Dengue fever.