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Original Article

PAFMJ. 2016; 66(0): S16-S21


CLINICAL SPECTRUM, PROGRESS OF DISEASE, GRADES OF SEVERITY AND OUTCOME OF CHILDREN WITH DENGUE FEVER

Syed Qamar Zaman, Emran Roshan, Arshad Mahmood, Shahid Mahmud.

Abstract
Objective: To study the clinical spectrum, progress of disease, grades of severity and outcome of children with dengue fever.
Study Design: A descriptive study.
Place and Duration of Study: Pakistan Naval Ship (PNS) Shifa Hospital, Karachi from August 2011 to November 2013.
Material and Method: A total of 50 children of either gender aged 5 months to 13 years having dengue infection admitted in child ward at PNS Shifa Naval Hospital Karachi gave consent to participate in the study.
All children with dengue IgM antibodies positive by ELISA test were included in the study. Dengue fever was classified according to WHO classification of dengue infections and they were managed according to the grading of severity.
Results: A total of 50 patients with dengue serology positive were studied. Mean age of children was 7.4 years with interquartile range 4.6 and majority were male (56%). Children commonly presented with fever 50(100%), tachycardia 35(70%), vomiting 24(48%), skin rashes 16(32%), headache 14(28%), abdominal pain 12(24%), hepatomegaly 12(24%), bleeding manifestations 10(20%) and myalgias/parasthesias 9(18%). Laboratory investigations revealed thrombocytopenia in 21(42%) patients, anemia 17(34%), leukopenia 13(26%), deranged prothrombin time/partial thromboplastin time (PT/PTT) 22(44%) and increased hematocrit 9(18%). Patients with dengue shock syndrome required supportive therapy with blood products and inotropic support and had a longer hospital stay. Mortality in the study was 4%.
Conclusion: Any child with fever, headache, vomiting, pain abdomen, significant bleeding manifestations, hepatomegaly, thrombocytopenia and raised hematocrit should be suspected to have dengue infection.

Key words: Bleeding manifestations, Dengue, Leucopenia, Skin rashes, Thrombocytopenia, Vomiting



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