ABSTRACT
Background: Clinical profile of dengue is variable including neurological manifestations like encephalopathy and encephalitis which are not being reported very frequently. This study is an attempt to know the cerebrospinal fluid (CSF) finding in dengue infected patients with neurological manifestations in a tertiary care hospital Eastern Odisha.Methods: Study conducted from August 2018 to July 2019 comprising of 100 dengue seropositive (NS1/IgM/IgG) patients of age >15 years in IMS and SUM Hospital.Results: A total of 100 (66 boys and 34 girls) hospitalised patients (Age >15 years) diagnosed as dengue were enrolled in our study. Total 20 cases Cerebrospinal fluid analysis has been done in which we found 70% (13 cases) unclassified viral meningitis, 15% (3 cases) bacterial meningitis, 5% (1 case) tuberculous meningitis, 5% (1 case) herpes encephalitis and 5% (1 case) Japanese encephalitis. Neurological manifestations in all dengue sero positive cases (100) found 30% headache, 18% altered sensorium, 5% seizure, 4% syncope, 3% papilloedema, 1% CN palsy and 11% meningeal signs.Conclusions: Dengue meningoencephalitis must be thought of in differentials of all febrile encephalopathy. This study brings out the incidence of different meningoencephalitis on the bases of CSF analysis including coinfections. So in dengue patients with neurological manifestation should do CSF analysisfor better outcome of a disease.
ABSTRACT
Background: Dengue is a vector borne disease by four different serotypes of dengue virus transmitted by bite of female Aedes mosquito. It is an acute febrile illness characterised by myalgia, joint pain, gastrointestinal manifestations. Complications like dengue hemorrhagic fever (DHF) and Dengue shock syndrome (DSS) , Extended Dengue Syndrome(EDS) may be fatal for patients. Authors analyse different clinical spectrum of of manifestations, complications and correlation bleeding to platelet level.Methods: This study conducted from July 2017 to December 2018 comprising of 100 dengue patients of age more than 15 years in IMS & SUM Hospital.Result: Out of 100 dengue patients’ males 73% and females 27%. From the patients 57% were NS1 Antigen positive, 29% IgM positive, 9% NS1 and IgM positive, 4% IgM and IgG positive and 2 % with all NS1, IgM, IgG positive. In our series in clinical manifestations, all cases (100%) presented with fever, myalgia (78%), headache (53%), rashes (14%), nausea, pain abdomen (21%) loose motion (17%), and Retro-orbital pain (6%). Bleeding manifestations in any form was seen in 39% cases like Purpura or Petechie (23%), malena (18%), hematemesis ( 2% ), epixtasis (6%), Gum bleeding (2%), Hematuria (1%), and Ophthalmic bleeding like sub conjunctival hemorrhage, intra-vitreal hemorrhage in 8% cases. Complications detected e.g. hepatopathy in 53%, nephropathy. 4%, ascites 8%, pneumonia 7%, DSS (4%), Multi Organ Dysfunction (MODS) (4%), DHF (8%) and EDS in 2% cases. It was observed that 95.8% of patients with platelet counts between 20,000-50,000/cu.mm and 61% of patients less than 25000 had bleeding manifestations.Conclusion: Wide clinical spectrum of manifestations and complications makes it common differential diagnosis of acute febrile illnesses and bleeding manifestation does not always corelate with lower platelet count.