Dengue In Infancy

Abstract

Introduction: Dengue virus infection is a major public health problem in Thailand and most countries of the world. It has a many varieties of clinical manifestations ranging from self-limited illness to fulminant course resulting to death. Most dengue virus infection in infant have asymptomatic. However, severe dengue also occurs in infants. Prompt recognition of dengue is important for appropriate case management, particularly in infants whom febrile illness from other causes is common.
Objective: To assess the clinical manifestations of dengue infection in infants.
Patients and Methods: A retrospective descriptive study was performed by reviewing the medical records of dengue patients aged 0-2 years admitted in Chumphon Khet Udomsak Hospital from January 1, 2014 to December 31, 2017. The diagnosis of dengue patients adhered to World Health Organization dengue definition and classification.
Result: 32 under 2 years old dengue patients (males : females ratio was 1:1) were hospitalized to Chumphon Khet Udomsak Hospital during the study period. All of these were classified to Dengue Fever (DF) 53.1%, Dengue Hemorrhagic Fever (DHF) 40.6% and Dengue Shock Syndrome (DSS) 6.3%. The average age of the patients was 12.4 months and the youngest patient was 5 day old. The clinical features presented with fever (100%), positive tourniquet test (72.3), skin rashes (46.7%) coryza and diarrhea (43.8%), cough, vomiting and anorexia (37.5%), hepatomegaly (30.3%) drowsiness (28.1%), convulsion (12.5%), respiratory distress (6.3%) and neonatal jaundice ( 3.1%).
The mean values of the complete blood count (CBC)
parameters included minimum white blood cell count were 5,011.5/mm3 (maximum percent of atypical lymphocytes, lymphocytes and neutrophils were 2.7 %, 68.3 % and 20.7 %, respectively.) maximum hematocrit concentration were 37.6 % and minimum platelet count were 54,221/mm3. The mean values of liver function test (LFT) was shown maximum AST 426.1 U/L, maximum ALT 147.6 U/L and maximum ALP 170.3 U/L. There was no mortality.
Conclusion: The dengue patients in this study had dengue fever and Dengue hemorrhagic fever in a similar ratio. Common symptoms were fever, positive tourniquet test, skin rashes, coryza, diarrhea, cough, vomiting, anorexia, hepatomegaly, drowsiness, convulsion, respiratory distress, and neonatal jaundice. Hepatic involvement in dengue presents with elevated transaminases.