AN EPIDEMIOLOGICAL STUDY, CLINICOPATHOLOGICAL CORRELATION AND MANAGEMENT OF DENGUE FEVER

BACKGROUND: Dengue fever is an arthropod borne viral syndrome. OBJECTIVE: This study evaluated the newer signs and symptoms, to come to a bedside diagnosis of dengue fever and to predict the prognosis on the basis of clinical features and investigations. METHODS: This was a prospective study and included children aged upto 15 years, admitted in the pediatric ward over 2 year period. Dengue like fever was defined according to WHO guidelines and then newer signs and symptoms and lab investigations were looked for,and treated symptomatically according to WHO guidelines.RESULTS: Most of the children included were in the age group of 6-12 years with mean age being 5.3 years. Male to female ratio was 1.3:1 . Maximum patients were seen in winter with peak in October. Out of 90 children 13.3 % of DF , 48.89 % DHF, 37.78% DSS. The newer clinical features were found to were Pruritus (80%)on recovery ,retro orbital pain(35%),Anorexia 68% ,Sore throat 30% , Fever(100%), Scrotal oedema (10%), Loose stools(20%), Cardiomyopathy (10%), Encephalopathy (1%), Menorrhagia(20%). One child had presented with Autism /ADHD on followup. Mortality rate 8.8% and all belonged to DSS group. Poor prognostic factors for death were vomiting, tachypnea ,convulsions, fluid collection in lungs, abdomen ,altered sensorium, convulsions , raised SGPT and secondary infections.Fluid therapy (Oral / IV) was used in all Platelets and blood transfusion was given in 20% and 13.3 % respectively. Ionotropes were used for DSS cases. CONCLUSIONS: The timely appropriate identification and timely management of Dengue fever go a long way in reducing mortality in dengue.