Role of sonography in the assessment of dengue fever with serological correlation

Basawaraj NG, T. Arul Dasan, Savitha S Patil, Deepashri B.


Background: Dengue, caused by a flavivirus has emerged as a major public health problem in the Indian subcontinent. This study was to assess severity of disease by ultrasound findings and to correlate ultrasound findings with blood platelet count.

Methods: A Cross sectional study carried out on 210 subjects who had serologically proven dengue fever were included in the study. Ultrasound of abdomen, pelvis and thorax was performed and imaging features were analysed by descriptive and analytical statistics using SPSS version 16. Chi-Square test used and P values ≤ 0.05 was considered to be statistically significant.

Results: Mean age of patients 42± 19 years with 106(50.5%) males and 104(49.5%) females. The Gall bladder wall thickening was noted in majority (92.8%) of the study subjects followed by Right peri-renal collection in 112(53.3%), Splenomegaly in 105(50.0%) subjects and Hepatomegaly in 66(31.4%). The sonographic abnormalities including Gall bladder wall thickening, Right, Left and Bilateral perirenal collection, Splenomegaly, Hepatomegaly, Right and Left pleural effusion, were significantly higher in study subjects with decreased platelet count.

Ascites was the commonest finding in 76 study subjects with platelet count between 60000-79000 (36.2%) and in 144 study subjects (68.5%) in the 20-59 years age group. As the   platelet count decreased the severity of ascites increased and was statistically significant (p≤0.05).

Conclusions: A patient who presents with sonographically recognizable complications is more likely to have disease that requires immediate and aggressive management.



Sonological abnormalities, Dengue fever, Dengue, Platelet count, Serology

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WHO South East Asia Regional Office Dengue situation update. September 2012.

Sehgal A, Gupta S, Tyagi V, Bahl S, Singh SK, Puliyel JM. Gall bladder wall edema is not pathogenic of dengue infection. J Trop Pediatr. 2002;48(5):315-16.

Shepard SD, Halasa YA, Tyagi BK, Adhish SV, Nandan D, Chellaswamy V et al. Economic burden of Dengue illness in India. Am. J. Trop. Med. Hyg 2014;91:1235–42.

Raheel U, Faheem M, Riaz MN, Kanwal N, Javed F, Zaidi NSS et al. Dengue fever in the Indian subcontinent- an overview. J Infect Dev Ctries 2011;5:239-47.

Joshi P, Ratham VG, Sharma S. USG findings in dengue haemorrhagic fever- Our experience in the recent epidemic. Indian J Radiol Imaging 1997;7:189-92.

Dengue: Guidelines for diagnosis, treatment, prevention and control. 2009. A joint publication of the World Health Organization (WHO) and the Special Programme for Research and Training in Tropical Diseases (TDR).

Oliveira RVB, Rios LTM, Branco MRFC, Braga Júnior LL, Nascimento JMS, Silva GF, Bandeira KP. Usefulness of ultrasonography in children with suspected dengue haemorrhagic fever: a literature review. Radiol Bras. 2010;43:401–7.

National Vector Borne Disease Control programme. Annual Report 2014-15.

Santhosh VR, Patil PG, Srinath MG, Kumar A, Jain A, Archana M. Sonography in the diagnosis and assessment of dengue fever. J Clin Imaging Sci 2014;4:14.

Martina BEE, Koraka P, Osterhaus ADME. Dengue virus pathogenesis: An integrated view. Clin Microbiol Reviews. 2009;10:564-81.

Balasubramanian S, Janakiraman L, Kumar SS, Muralinath S, Shivabalan S O. A reappraisal of the criteria to diagnose plasma leakage in dengue haemorrhagic fever. Indian Pediatr 2006;43:334-9.

Srikiatkhachorn A, Krautrachue A, Ratanaprakarn W, Wongtapradit L, Nithipanya N, Kalayanarooj S et al. Natural history of plasma leakage in dengue haemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J. 2007;26:283–90.

Venkata Sai PM, Krishnan R. Role of ultrasound in dengue fever. The British Journal of Radiology. 2005;78:416–18.

Pramuljo HS, Harun SR. Ultrasound findings in dengue haemorrhagic fever. Pediatr Radiol 1991;21:100-02.

Setiawan MW, Samsi TK, Pool TN, Sugianto D, Wulur H. Gallbladder wall thickening in dengue haemorrhagic fever: an ultrasonographic study. J Clin Ultrasound. 1995;23(6):357-62.