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Dengue hemorrhagic fever in infants
1Department of Pediatrics, Chon Buri Regional Hospital, Ministry of Public Health, Thailand. suchat845@hotmail.com
Insights
Dengue hemorrhagic fever (DHF) in infants under one year old in Thailand presented with fever and hepatomegaly. Most infants experienced primary DHF infection and recovered fully with prompt treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Dengue hemorrhagic fever (DHF) is a significant public health concern, particularly in tropical regions.
- Infants represent a vulnerable population for severe infectious diseases, including DHF.
- Limited data exists on the clinical presentation and outcomes of DHF specifically in infants.
Purpose of the Study:
- To describe the clinical characteristics, co-infections, and outcomes of dengue hemorrhagic fever in infants.
- To analyze the severity and management of DHF in this young age group.
Main Methods:
- Retrospective case series of 19 infants diagnosed with serologically-proven DHF.
- Data collected from admissions at Chon Buri Regional Hospital, Thailand (1995-1998).
- Analysis of clinical manifestations, laboratory findings, co-infections, and disease severity (WHO DHF grading).
Main Results:
- The study included 19 infants (3-12 months old), with a peak incidence at 8 months.
- Common symptoms included high fever, coryza, and hepatomegaly; rash was infrequent.
- Co-infections like pneumonia and sepsis were noted in 21% of cases.
- Hemorrhagic manifestations occurred in the skin and gastrointestinal tract.
- Thrombocytopenia and hemoconcentration were prevalent (95% and 84%).
- Most cases (95%) were primary infections.
- DHF severity ranged from Grade I (21%) to Grade III/dengue shock syndrome (32%).
Conclusions:
- Dengue hemorrhagic fever in infants presents with distinct clinical features and can be severe.
- Prompt diagnosis and effective management are crucial for favorable outcomes in infants with DHF.
- Further research is needed to understand long-term sequelae and optimize prevention strategies in this age group.
Abstract:
A report of 19 cases of serologically-proven dengue hemorrhagic fever (DHF) in infants aged 3-12 months who were admitted to the Department of Pediatrics, Chon Buri Regional Hospital, Thailand, during 1995 to 1998. Subjects were 8 males and 11 females, with the peak age of 8 months. Four cases (21%) had DHF and other common co-infections ie pneumonia (2 cases), Staphylococcus aureus sepsis (1 case) and Haemophilus influenzae meningitis (1 case). The clinical manifestations of the 15 DHF cases were high fever (100%), coryza (93.3%), hepatomegaly (80%), drowsiness (53.3 %), and vomiting (46.7%); rash was observed in only 27%; one-fifth developed febrile convulsions. Sites of bleeding were the skin (petechiae) 58%, gastrointestinal system (melena) 16%, and mucous membrane (epistaxis) 5%; thrombocytopenia and increased hematocrit (> or =20%) were noted in 95% and 84% respectively. The majority of the patients (18 cases, 95%) had primary infection; only one (5%) had secondary infection. The clinical severity of the DHF was Grade I, II, and III (dengue shock syndrome) in 21%, 47% and 32% of cases respectively. After appropriate and effective management, all the infants recovered fully.