Dengue Infection In Cancer Patients

Abstract

Objective: To study the clinical behaviour of dengue infection in cancer patients.
Material and Methods: We reviewed medical records of cancer patients who were diagnosed
with dengue infection in year 2011 as per discharge notes. Patients fulfilling revised dengue
WHO/TDR classification with positive dengue IgM serologies were finally chosen for analysis.
Results: From initially screened 63 patients, 43 fulfilled revised dengue WHO/TDR
classification criteria, 31 (of these 43) with positive dengue IgM were finally analysed. There were
16 males and 15 females, mean age was 39.0 (23.0) years. 23 patients were ≥ 18 years of age.
81% patients reported within first three days of illness. Major cancer bulk was from solid
organ cancer group (n=21) followed by haematological group (n=10). Presenting features were
fever (100%) followed by aches (58.1%), haemorrhagic manifestations (35.5%), vomiting (29%)
and diarrhoea (25.8%). Twelve (38.7%) patients developed severe dengue with one death
making 3.2% crude mortality rate.
Conclusion: The spectrum of dengue infection severity in cancer patients seems to be different
from general population. Clinically dengue was more severe with solid organ cancers as
compared to hematologic cancers possibly highlighting the role of cellular mediated immunity.
Other risk factors identified were relatively elder age and more co-morbid conditions.