Manifestaciones clínicas y hallazgos de laboratorio de una serie de casos febriles agudos con diagnóstico presuntivo de infección por el virus dengue. Quindío (Colombia)

Abstract

Objective To characterise the clinical and laboratory findings on a series of febrile cases with a presumptive diagnosis of dengue virus infection in Quindío, Colombia. Materials and methods This study was conducted from January to July 2013. Blood samples were obtained from patients suspected of dengue virus infection from Quindío department hospitals. These samples were tested for dengue, leptospira, malaria, hepatitis B and rickettsiosis. To confirm dengue infection, we performed viral isolation in C6/36HT cells and dengue serotyping by RT-PCR; liver function tests, complete blood counts and cytokine levels. Results Of 149 cases, 43% were infected by dengue, 4% leptospira, 6.8% rickettsia, one case of malaria and one case of hepatitis b. We obtained 5 clinical isolates of DENV2 and DENV3 that evidenced co-circulation of serotypes 2, 3, and 4. We found that AST/ALT levels, platelet count, rash and abdominal pain were good markers of infection by dengue, while jaundice and lumbar pain suggested leptospirosis. Cytokine levels revealed that IL-10, TNFα varied significantly in dengue compared with other diagnostics and that IL-17α showed significant differences in individuals with severe dengue. Conclusions Dengue was confirmed as an important aetiology of acute febrile ictero-haemorrhagic syndrome in Quindío, but leptospirosis and rickettsia also play an important role. However, 44% of the cases were classified as undetermined febrile syndrome.