Cuadro clinico de la fiebre hemorragica del dengue/sindrome del choque del dengue en el adulto

RESUMO

Previous descriptions of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) in adults have been limited. This article assesses the disease cases of 130 Cuban adults who became ill during the 1981 dengue epidemic in that country and who were diagnosed as having hemorrhagic dengue. One hundred and four of these subjects (comprising Group 1) were admitted to one of three major Havana hospitals and recovered. The other 26 (comprising Grupo 2) died. The information cited was obtained from the two groups' clinical histories, serologic testing of the Grupo 1 subjects, and autopsy reports on the Group 2 subjects. Age did no appear to be a risk factor among these adult subjects; but race and sex appeared to play a role in the disease, a disproportionate share of both groups being white and female. Classical dengue symptoms (fever, headache, asthemnia, myalgia, arthralgia, retroorbital pain, and occasionally rash) predominated in both groups. Digestive symptoms (nausea and vomiting, anorexia, abdominal pain, diarrhea, and hepatomegaly) were also common. Hemorrhagic symptoms were confirmed in 90. and 65. of the Group 1 and Group 2 subjects, respectively, and shock occurred in all the fatal cases. The study subjects typically developed classical dengue symptoms at the outset, followed by digestive and hemorrhagic symptoms. The Group 1 subjects recovered after an average of seven days of illness