Clinical Spectrum of Dengue Fever in Pediatric Age Group At A Tertiary Care Hospital In Lahore

Abstract

Objective: To assess frequency of various clinical presentations of dengue fever in pediatric age
group at a tertiary care hospital in Lahore.
Methods: A cross sectional survey was conducted from Dec 2012 to Sep 2013 in pediatrics
department of Jinnah hospital Lahore. 150 patients were enrolled as per inclusion criteria.
Clinical features were abstracted on a standardized Performa and investigations were done,
including complete blood count, hematocrit, anti-dengue IgM (If fever more than 5 days), NS1
antigen (If fever less than 5 days) by Elisa and ultrasound scan of abdomen to document free fluid
in abdominal or thoracic cavity. Data was analyzed using SPSS Version 17.
Results: One hundred and fifty patients with mean age of 8.4 years (SD of ± 2.8 years) were
enrolled. 86 patients (57.3%) were males with male to female ratio of 1.3: 1. High grade fever was
present in all the 150 patients (100%) & Diarrhea in 21(14 %) patients. Other clinical features
included: petechiae in 25 (16.3%), epistaxis in 20 (13.3%), hematemesis in 8 (5.3%),
hepatomegaly in 33(22%) and splenomegaly in 15 (10%) subjects. The evidence of dengue
hemorrhagic fever was seen in 23 patients (15 %), while there was no case of Dengue Shock
Syndrome.
Conclusions: Most of dengue fever cases were from 5 to 10 years of age group. High grade fever
was the most common clinical manifestation of dengue fever, followed by hepatomegaly,
petechiae, diarrhea, epistaxis, splenomegaly and hematemesis. Dengue fever was more
common in males as compared to females, and about one in six cases had dengue hemorrhagic
fever.