DIFFERENT CLINICAL PRESENTATIONS OF DENGUE AT ASTTH

Abstract

Objective: To observe the different clinical presentations of dengue fever in patients presenting
with acute febrile illness.
Material & Methods: This retrospective observational study was conducted in medicine
department, Akhtar Saeed Trust Teaching Hospital, Lahore in September 2011. Patients
presenting with acute febrile illness in both OPD and emergency were included. History was
taken and clinical examination was done. Blood samples were collected for Complete blood
count, Liver function tests, Renal function tests and serology for Dengue virus IgM by ELISA.
Symptoms and investigations were analyzed.
Results: Total 300 patients were included in the study. Females were187 (62.3%) and males
were 113 (37.7%). Mean age of patients was 33.4 years. Headache was the most common
presentation in 284 (94.6%) patients, myalgia was present in 271 (90.3%) patients, fever was
present in 257 (85.6%) patients, vomiting in 190 (63.3%) and rash with petechie in 53 (17.6%)
patients. Leukopenia and thrombocytopenia was present in all 300 patients. Liver function tests
were deranged in 209 (69.7%) patients and dengue IgM was present in 127 (42.3%) patients.
Serum urea was deranged in 113 (37.7%) patients.
Conclusion: Fever associated with chills and rigors, headache, myalgia, vomiting, rash,
petechie and hemorrhagic manifestations, leucopenia, thrombocytopenia and raised ALT are
satisfactory parameters to screen for suspected dengue virus infections. However, diagnosis
cannot be confirmed unless supported by dengue specific IgM serology