Clinical and laboratory profile of different dengue sub types in dengue virus infection

Niloy Gan Chaudhuri, S. Vithyavathi, K. Sankar


Background: Dengue infection, an arthropod-borne viral hemorrhagic fever is caused by Arbovirus of Flavivirus genus and transmitted by Aedes aegypti, Aedes albopictus. Liver involvement in dengue fever is manifested by the elevation of transaminases representing reactive hepatitis, due to direct attack of virus itself or the use of hepatotoxic drugs. The objective of the study was to investigate clinical and laboratory profile of different dengue sub type’s patients admitted for dengue fever.

Methods: All the adult patients with clinical features such as fever and later confirmed positive by dengue serology test admitted as inpatients were included in the study. Vitals parameters and systemic examination were performed. Investigation of dengue serotology, liver function test, routine investigations like hemoglobin percentage, total count, ESR, packed cell volume, platelet count, partial thromboplastin and activated partial thromboplastin time, blood urea, serum creatinine, and blood sugar estimation were done.

Results: On comparison of clinical signs in different dengue subgroups it was observed that the mean value of pulse, blood pressure and respiratory rate were significantly more deranged in the DSS group as compared to the DF group. Platelet count was significantly lower in all the sub groups whereas PT/aPTT was more dearranged in the DSS and DHF group as compared to the DF group. Comparison between the mean values of liver function test in different dengue sub groups had been shown, elevated transaminases, hypoproteinaemia and hypoalbuminaemia, in higher frequency in dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) as compared to classical dengue fever (DF) (P values significant). SGOT was significantly higher than the SGPT levels and SGOT was much more elevated in the DSS sub group compared to the DFS and DF group.

Conclusions: The liver enzymes serum aminotransferase levels were significantly raised in patients with dengue shock syndrome compared to other two groups. Serum aminotransferases directly correlate with severity of infection in all the sub groups. Patients with secondary dengue infection were more prone for developing bleeding manifestations and shock syndrome. 



Full Text:



World Health Organization. Geneva, Switzerland: WHO; 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Publication – 2009, No of pages 147, ISBN – 9789241547871.

Gubler DJ: Dengue. In: Monath TP, ed. The Arboviruses: Epidemiology and Ecology, Boca Ration: 1988:223-260.

U.s. Department of health and human services Centers for Disease Control and Prevention-Information sheat, 2014.

Cordeiro MT, Ernesto T, Marques A. Reliable classifier to Differentiate primary and secondary acute Dengue infection based on IgG elisa. Journal of Clinical Micro-biology. 2009;43(6):2793-7.

Rico-Hesse R. Molecular evolution land distribution of dengue virus type 1 and type 2 in nature. Virology. 1990;174:479-93.

WHO: Dengue Hemorrhagic Fever: Diagnosis, Treatment and Control, Geneva, World Health Organization, 1997.

Chhina RS, Goyal O, Chhina DK, Goyal P, Kumar R, Puri S. Liver function tests in patients with dengue viral infection. Dengue Bulletin. 2008;32:110-7.

Makroo RN, Raina V, Kumar P, Kanth RK. Role of platelet transfusion in the management of dengue patients in a tertiary care hospital. Asian J Transfus Sci. 2007;1(1):4-7.

Hawker F. Liver dysfunction in critical illness. Anaesth Intensive Care. 1991;19:165-81.

Burke T. Dengue hemorrhagic fever: a pathological study. Trans R Soc Trop Med Hyg. 1968;62(5):682-92.

Babaliche P, Doshi D. Catching Dengue Early: Clinical Features and Laboratory Markers of Dengue Virus Infection. West Bengal Journal of tropical medicine Trop. 2013;48:65-9.

Srickaikul T, Nimmannitya S. Hematology in dengue and dengue hemorrhagic fever. Bailliere’s Clin Hematol. 2000:261-273.

Marchette NJ, Halkstead SB, FalkerJr WA. Studies on the pathogeneses of engue infection in moinkeys III: Sequential distribution of virus in primary and heterologous infections. The Journal of Infectious Diseases. 1973;128:28-30.

Sumarmo WH, Jahja E, Gubler D, Suharyono W, Sorensen K. Clinical observations on virologically confirmed fatal dengue infections in Jakarta, 2003: Indonesia. Bull. World Health Organ. 2003;61:693-701.

Wahid SF, Sanusi S, Zawawi MM, Ali RA. A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classic dengue fever. Southeast Asian J. Trop Med Public Health. 2002;31:259-63.

Souza LJ, Alves JG, Nogueira RMR, Neto CG, Bastos DA, da SiveSiqueira EW, et al. Aminotransferase changes and acute hepatitis in patients with dengue fever: analysis of 1585 cases. Braz J Infect Dis. 2006;8:156-63.

Luis Angel Villar-Centeno, Fredi Alexander Díaz-Quijano, Ruth AralíMartínez-Vega. Biochemical Alterations as Markers of Dengue Hemorrhagic Fever. The American journal of tropical medicine and hygiene. 2013;78(3):370-4.

Shukla V, Chandra A. A study of hepatic dysfunction in dengue. J Assocphysican India. 2013;61(7):460-1.