Primary dengue infection: what are the clinical distinctions from secondary infection?

C Pancharoen1, J Mekmullica, U Thisyakorn

  • 1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. chitsanu.P@chula.ac.th

Insights

Primary dengue infection in children is common and less severe than secondary infections. Key differences in symptoms like rash and diarrhea, and lab findings, help distinguish primary from secondary dengue cases.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Virology

Background:

  • Dengue infection poses a significant health challenge, particularly in pediatric populations.
  • Distinguishing primary from secondary dengue infections is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To determine the prevalence of primary dengue infection in children.
  • To identify distinct clinical and laboratory features differentiating primary from secondary dengue infections.

Main Methods:

  • Retrospective review of 996 children diagnosed with dengue infection at Chulalongkorn Hospital, Bangkok (1988-1995).
  • Serological confirmation of primary dengue infection in 139 cases.
  • Comparison of clinical manifestations and laboratory findings between primary and secondary dengue infections.

Main Results:

  • Primary dengue infection accounted for 14.0% of cases, with a mean age of 4.8 years.
  • Children with primary dengue showed increased frequency of coryza, diarrhea, rash, and seizures, and less vomiting and abdominal pain compared to secondary infections.
  • Primary dengue infections exhibited lower maximal hematocrit and neutrophil levels, and higher lymphocyte percentages, with a higher incidence of dengue fever and lower incidence of dengue shock syndrome.

Conclusions:

  • Primary dengue infection is a notable clinical problem in children and is generally less severe than secondary infections.
  • Distinct clinical clues and laboratory findings aid in differentiating primary from secondary dengue infections in pediatric patients.

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