1. CLINICAL PROFILE OF DENGUE FEVER
Dr. Raghavendra Setty. A
Prof. Vijayashankara.C.N
SDUMC,Kolar

2. Introduction
Dengue is caused by dengue virus, belonging to Togavirus family. Transmitted by Mosquitoes of Stegomyia family- Aedes Aegypti.
Around1 million cases of dengue is being reported every year .

3. DF DENGUE DHF ASYMPTOMATIC SYMPTOMATIC DHF UNDIFFERENTIATED FEVER
DENGUE FEVER
NO SHOCK
SHOCK
WITHOUT HAEMG
WITH UNUSUAL
HAEMG DF
DHF

4. WHO CLASSIFICATION GRADE 1
FEVER + CONSTITUTIONAL SYMPTOMS+TOURNIQUET TEST
GRADE 2
GRADE 1 + SPONTANEOUS BLEEDING
GRADE 3
GRADE 2 + CIRCULATORY FAILURE
GRADE 4
PROFOUND SHOCK
WHO CLASSIFICATION.
4 GRADES ON THE BASIS OF PLATELETS AND HEMATOCRIT.
GRADE 1 -
GARDE 2 -
GRADE 3 -
GRADE 4 -
3 , 4 AND THROBOCYTOPENIA, HEMOCONCENTRATION -DSS

5. AIM OF THE STUDY
To Compare the clinical features with the outcome (Death or Discharge) in children's with dengue fever.

6. MATERIALS AND METHODS Retrospective Study.
Settings - Pediatric Ward of R L Jalappa Hospital.
Duration – 1yr ( June 2002 to May 2003 ).
Inclusion Criteria - Cases positive for IgM Dengue antibodies were considered.
Independent Sample T-test was applied as test of significance.
Descriptive statistics were applied to determine the more frequently observed clinical features.

7. RESULTS TOTAL CASES-22 AGE (mean) - Death - 0.57yrs
Discharge – 6.05yrs
SEX -
Discharge
Death
MALE(10) 9 1
FEMALES(12) 3

8. Clinical Features PALLOR 18 78.3% FEVER 17 73.9 %
TACHYCARDIA,TEMP(>100oF) 13
55.9%
TACHYPNOEA 9
38.5%
CONVULSIONS,BLEEDING SITE 5
21.7%
ABDOMINAL PAIN 4
17.4%

9. Cont….. BODYACHE, HEADACHE, THROAT PAIN, RHINITIS 3 13.0%
CONCIOUSNESS - LETHARGY
ALTRD SENS
COMA 2 1
8.7%
4.3 %
PULSE VOLUME GOOD
LOW
VERY LOW 19
82.6%
4.3%

10. INVESTIGATIONS HEMOGLOBIN (<10gm/dl) 11 50% TOTAL LEUCOCYTE COUNT
(>11,000)
HEMATOCRIT (>30%) 12
54.5%
PLATELET COUNT(<1,50,000) 9
45.5%

11. Classification DENGUE FEVER 12 54.5% DENGUE HEMORRHAGIC FEVER 9 45.5%
DENGUE SHOCK SYNDROME 1
4.5%

12. TOTAL LEUCOCYTE COUNT(>11,000).
75% of the children among who died had > count.
44.5% of the children among who were discharged had >11000 count.
p value was statistically significant (0.021).

13. Clinical features and poor outcome
DEATH(4)
DISCHARGE(18)
PALLOR
4(100%)
14(77%)
CONVULSIONS
2(50%)
2(11%)
TACHYPNOEA
7(38%)
TLC(>11000)
3(75%)
8(44%)

14. DISCUSSION
According to literature fever is present in almost all cases of dengue,but we had only 73% of cases presenting with fever.
Symptoms like myalgia, headache, abd pain, throat pain, eye sore, rhinitis, convulsion were present in very few cases.
18 children were clinically pale and 12 of them with Hb <10 gms was significant, but probably explains the nutritional anemia.

15. Cont…..
Though 13 children had hematocrit >30% only 3 of them had low volume pulse which suggest infrequent occurrence of Dengue shock
Fever, pallor, tachypnoea, convulsions and leucocyte counts were associated more with poor outcome.

16. Cont…..
Independent T-test was applied between outcome and all the variables and found significant correlation only between total leucocyte count and the outcome(p-0.021).

17. Conclusion
Though Dengue fever has various clinical manifestations none were specific to the disease.
Fever was the only clinical feature which was maximally associated.
Total leucocyte count may determine the outcome
More prospective study and more number of cases are to be analysed to know the exact clinical manifestation which may determine the outcome.

18. THANK U