The Clinical and Serological Profile of Pediatric Dengue

Abstract

Objective: To classify suspected dengue into dengue, dengue with warning signs and severe dengue, based on clinical features as per the revised WHO guidelines with special emphasis on serology. Methods: It was a prospective cross-sectional study for five years from 2011–2016 in a tertiary care medical college hospital in Bangalore. All cases of fever of three to five days duration with symptoms like dengue were enrolled for the study. They were categorized into three groups as per the Revised WHO 2012 criteria. Laboratory parameters, serology, ultrasound abdomen and X-ray were done in almost all patients. Data was analysed by SPSS software, version 16, and different groups were compared with Chi square test. Results: Five hundred sixty eight children were diagnosed to have dengue fever; 4.2% of the sample belonged to infancy. Majority were in the age group of 5–10 y (42.6%). Fever and flushing were present in majority of the children. Gastrointestinal bleed was more commonly seen in the severe dengue group. Dengue nonstructural protein antigen (NS1Ag) was positive in 78%, immunoglobulin M (IgM) in 15.8% and immunoglobulin G (IgG) in 14.6%. Children with IgG had more complications, though not statistically significant. Mortality was reported in 1.2%. Dengue serology helped to confirm the diagnosis, however did not help in patient management. Conclusions: There is a considerable overlap in the symptomatology of dengue with warning signs and severe dengue. More studies are required on the severity and type of response to treatment in infants and obese adoloscents with severe dengue.