Published: 2019-06-28

Dengue: experience from a tertiary care centre in Northern Karnataka, India

Mohammad A. Waheed


Background: Epidemiology of dengue infection is evolving, and research gap exists in the region. The clinical features, laboratory parameters, complications and treatment outcomes of patients diagnosed of dengue infection at a tertiary care centre were analysed in the present study.

Methods: More than 12 years old patients, presenting with features suggestive of acute febrile illness were subjected to detailed history taking and thorough clinical examination. All the suspected cases were further evaluated with complete blood count, liver function test, kidney function test, along with ultrasonography of abdomen. Blood samples were tested for dengue antibodies (IgG and IgM) by hemagglutination inhibition method for confirmation of the diagnosis. The clinical course was closely monitored during hospital stay and complications and deaths, if any, were noted.

Results: Total 140 patients were studied. Fever (100%), headache (80%) and myalgia (73.6%) were the commonest symptoms. Thrombocytopenia (136, 97.1%) was the commonest hematological finding, while severe thrombocytopenia (<50,000/cu. mm) was observed in 38 (27.1%) cases. Hepatomegaly (61, 43.6%), splenomegaly (42, 30.0%), ascites (54, 38.6%), pleural effusion and gall bladder edema (18, 12.9% each) were the commonest findings on ultrasonography. Shock and ARDS were the major complications.

Conclusions: Dengue remains an important public health problem even at a tertiary care centre and strong suspicion is needed in adult patients with acute febrile illness. The management should focus on averting shock and ARDS, which would help in larger aim of reduction in mortality.


Clinical features, Complications, Dengue, Profile

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Beatty ME, Beutels P, Meltzer MI, Shepard DS, Hombach J, Hutubessy R, et al. Health economics of dengue: a systematic literature review and expert panel's assessment. Am J Trop Med Hygiene. 2011;84(3):473-88.

Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, et al. The global distribution and burden of dengue. Nature. 2013;496(7446):504.

Gubler DJ. Epidemic dengue/dengue hemorrhagic fever as a public health, social and economic problem in the 21st century. Trends Microbiol. 2002;10(2):100-3.

Rochlin I, Ninivaggi DV, Hutchinson ML, Farajollahi A. Climate change and range expansion of the Asian tiger mosquito (Aedes albopictus) in Northeastern USA: implications for public health practitioners. PloS One. 2013;8(4):e60874.

Wilder-Smith A, Gubler DJ. Geographic expansion of dengue: the impact of international travel. Med Clin North America. 2008;92(6):1377-90.

Ministry of Tourism, 2019. India Tourism Statistics at a Glance, 2018. Available at: Accessed May 30, 2019.

World Bank, 2019. India Overview. Available at: Accessed May 30, 2019.

Kakkar M. Dengue fever is massively under-reported in India, hampering our response. BMJ. 2012;345:e8574.

Halasa YA, Dogra V, Arora N, Tyagi BK, Nandand D, Sheparda DS. Overcoming data limitations: design of a multi-component study for estimating the economic burden of dengue in India. Dengue. 2011;35:1.

Chakravarti A, Arora R, Luxemburger C. Fifty years of dengue in India. Transactions of the Royal Soc Trop Med Hygiene. 2012;106(5):273-82.

Fazal F, Biradar S. Clinical and laboratory profile of dengue fever. J Evidence Based Med Healthcare. 2013;2(9):1136-47.

Gouthami M. Impact of pharmacist provided knowledge on dengue among selected school children. Int J Res Hosp Clin Pharm. 2018;1(1):1-10.

Government of India. Directorate of National Vector Borne Disease Control Programme 2008. Guidelines for clinical management of Dengue Fever, Dengue Hemorrhagic Fever and Dengue Shock Syndrome. Available at Accessed June 1, 2019.

Reiter P. Climate change and mosquito-borne disease. Environmental Health Perspectives. 2001;109(suppl 1):141-61.

Bandyopadhyay B, Bhattacharyya I, Adhikary S. A comprehensive study on the 2012 dengue fever outbreak in Kolkata, India. Virol J. 2013;2(1):13.

Gupta E, Dar L, Kapoor G, Broor S. The changing epidemiology of dengue in Delhi, India. Virol J. 2006;3(1):92.

Chakravarti A, Kumaria R. Eco-epidemiological analysis of dengue infection during an outbreak of dengue fever, India. Virol J. 2005;2(1):32.

Cobra C, Rigau-PĂ©rez JG, Kuno G, Vomdam V. Symptoms of dengue fever in relation to host immunologic response and virus serotype, Puerto Rico, 1990-1991. Am J Epidemiol. 1995;142(11):1204-11.

Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Developing Countries. 2012;6(07):551-4.

Soundravally R, Sankar P, Bobby Z, Hoti SL. Oxidative stress in severe dengue viral infection: association of thrombocytopenia with lipid peroxidation. Platelets. 2008;19(6):447-54.

Thomas EA, John M, Bhatia A. Cutaneous manifestations of dengue viral infection in Punjab (north India). Int J Dermatol. 2007;46(7):715-9.

Lin SF, Liu HW, Chang CS, Yen JH, Chen TP. Hematological aspects of dengue fever. Gaoxiong yi xue ke xue za zhi=Kaohsiung J Med Sci. 1989;5(1):12-6.

Parkash O, Almas A, Jafri SW, Hamid S, Akhtar J, Alishah H. Severity of acute hepatitis and its outcome in patients with dengue fever in a tertiary care hospital Karachi, Pakistan (South Asia). BMC gastroenterology. 2010;10(1):43.

Itha S, Kashyap R, Krishnani N, Saraswat VA, Choudhri G, Aggarwal R. Profile of liver involvement in dengue viral infection. National Med J India. 2005;18(3):127-30.

Lee K, Liu JW, Yang KD. Clinical characteristics, risk factors, and outcomes in adults experiencing dengue hemorrhagic fever complicated with acute renal failure. Am J Trop Med Hygiene. 2009;80(4):651-5.

Motla M, Manaktala S, Gupta V, Aggarwal M, Bhoi SK, Aggarwal P, Goel A. Sonographic evidence of ascites, pleura-pericardial effusion and gallbladder wall edema for dengue fever. Prehospital Disaster Med. 2011;26(5):335-41.

Venkata Sai PM, Dev B, Krishnan R. Role of ultrasound in dengue fever. British J Radiol. 2005;78(929):416-8.

Rodriguez-Tan RS, Weir MR. Dengue: a review. Texas Med. 1998;94(10):53-9.

Kamath SR, Ranjit S. Clinical features, complications and atypical manifestations of children with severe forms of dengue hemorrhagic fever in South India. Indian J Pediatr. 2006;73(10):889-95.