Clinical and laboratory profile of dengue infection in children

Area of Science:

• Pediatrics
• Infectious Diseases
• Epidemiology

Background:

• Dengue infection poses a significant public health challenge, particularly in tropical and subtropical regions.
• Understanding the clinical spectrum and risk factors for severe dengue is crucial for effective patient management.

Purpose of the Study:

• To investigate the clinical characteristics and serological profiles of dengue infections in children admitted to a hospital in Dhaka, Bangladesh.
• To differentiate between primary and secondary dengue infections and their association with disease severity.

Main Methods:

• A prospective, observational study of 100 seropositive dengue cases in children aged 8 months to 14 years.
• Serological testing using rapid strip tests to determine immunoglobulin M (IgM) and immunoglobulin G (IgG) status.
• Clinical data collection including symptoms, physical examination findings, and laboratory values.

Main Results:

• 85% of cases had secondary dengue infection (IgG positive), while 15% had primary infection (IgM positive).
• 89% of children presented with severe dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), compared to 11% with classical dengue fever (DF).
• Common symptoms included fever, vomiting, abdominal pain, and bleeding; severe cases showed higher rates of tachycardia, hypotension, hepatomegaly, high hematocrit, and thrombocytopenia.

Conclusions:

• Secondary dengue infections are predominant in this pediatric cohort, associated with a high burden of severe DHF/DSS.
• Clinical indicators like fever, vomiting, musculoskeletal pain, bleeding, hepatomegaly, thrombocytopenia, and high hematocrit warrant strong suspicion for DHF/DSS in epidemic settings.
• Further research into the pathogenesis of bleeding manifestations in dengue is needed, as tourniquet test and thrombocytopenia did not consistently correlate with bleeding.