Shankar Sikdar1, Ujjwal Bandyopadhyay2, Sutapa Das3, Mala Bhattacharya4
BACKGROUND
Dengue is a major public health concern in tropical Asian countries and a most
rapidly spreading mosquito borne viral disease with a 30 fold increase in global
incidence over the last five decades. Dengue is among the ten leading causes of
death in children ranging from 1 to 15 years of age in tropical Asian countries.
Complications of dengue fever are common in children. But very limited studies
are available on paediatric populations. The virus or non-structural protein (NS1)
interacts with platelets and coagulation factors. A combined effect of mild
disseminated intravascular coagulation, liver damage and platelet dysfunction
results in bleeding in dengue fever. With this scientific knowledge background,
the present study was undertaken to identify and document the changing
pattern of dengue infection in paediatric age group with a special emphasis on
laboratory findings of dengue cases in paediatric age group.
METHODS
The present descriptive study was conducted for two years in a state run
paediatric referral hospital. The sample was purposive by design and consisted of
patients who have been diagnosed as having dengue fever with warning signs
and admitted.
RESULTS
Fever was typically high grade (> 103 F) and most patients presented with
warning signs within 5 days of illness (64.2 % in year 2016 and 76.6 % in year
2017). Persistent vomiting and abdominal pain were the most common warning
signs in both the years. Thrombocytopenia was the commonest laboratory
finding. Bleeding in study subjects lead to < 50000 / cu mm platelet count. Most
common bleeding was gastrointestinal bleeding (39.2 % of study subjects with
platelet count < 50000 / cu mm presented with G. I bleeding).
CONCLUSIONS
Dengue illness comes with varied presentation. Atypical presentations can delay
the diagnosis. Early recognition of warning signs keeping the atypical
presentation in mind is important.
