Dengue virus infection: Need for appropriate laboratory tests for diagnosis and management of the condition in children during an outbreak.
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Date
2015-07
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Abstract
Background: Outbreaks of dengue infection occur in several parts of India with
clockwork precision closely related to changing seasons. Most recent outbreak in
Puducherry occurred between October 2012 and January 2013, affected a sizable
pediatric population. A prospective study was done to characterize the demographic,
diagnostic and clinical profi le of pediatric patients in a tertiary care center in
Puducherry. Materials and Methods: Data of patients serologically positive for
either dengue NS1 antigen or anti-dengue IgM antibodies were analyzed. Duration
of fever, platelet count, complications, risk factors, morbidity and mortality were
analyzed. Results: Among pediatric cases with fever who were screened for NS1/
IgM antibody during the recent outbreak, 161 (37.5%) tested positive. NS1 was
detected in 85% while 5.5% tested positive for IgM and 3% for IgG. Few (4.9%)
tested positive for both NS1 and IgM and 1.2% were positive for both NS1 and
IgG. The mean age was 6 years of which 9% were <1-year, the youngest being
1-month old infant. Mean duration of fever was 4 days. Vomiting was associated in
42% of cases. Thrombocytopenia (51%) and hepatomegaly (41%) were two major
observations. Among the NS1 positive cases, 49% had thrombocytopenia. IgM
alone and NS1 with IgM were associated with thrombocytopenia in 67% and 78%
respectively. 14 children had complications of dengue shock syndrome, and four
had dengue hemorrhagic fever. Totally, 22 of the children had platelet transfusion.
There was no mortality reported among any of these children. Conclusion:
Combination of clinical fi ndings and rapid NS1, IgM detection helped in confi rming
the diagnosis for appropriate management of dengue in children.
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Keywords
Dengue fever, NS1 Ag, pediatric cases
Citation
Palanivel Harshavardhini, Nair Shashikala, Subramaniyan Anandhalakshmi, Ratnam Philip Vivian Joseph, Kanungo Reba. Dengue virus infection: Need for appropriate laboratory tests for diagnosis and management of the condition in children during an outbreak. Indian Journal of Pathology & Microbiology. 2015 Jul-Sept 58(3): 328-331.