A Tertiary Care Hospital's Clinical Profile and Prognosis for Severe Dengue Infection in Children

Aim: The aim of the present study was to evaluate the typical clinical presentation, biochemical findings, and prognosis of severe dengue fever. Materials and Methods: This study was conducted at the Pediatrics Department of Krishna Mohan Medical College and Hospital, Pali Dungra, Sonkh Road, Mathura, Uttar Pradesh, India. Of all the dengue cases, 60 were deemed serious. Only adolescents (10-19) were considered for the study. Results: Among the 60 severe dengue cases, 53.3% (n=32) had Dengue shock syndrome (DSS), 18.3% (n=11) had Dengue Hemorrhagic Fever (DHF), and 11.6% (n=7) had Expanded Dengue Syndrome (EDS). After being admitted to the hospital, 13.3% (n=8) of the patients with DSS developed DHF, and 3.3% (n=2) of those with DHF developed grade EDS. The most common blood type among patients was B+, accounting for 38.3% (n=23), followed by O+ at 35% (n=21), A+ at 23.3% (n=14), and AB+ at 3.3% (n=2). Fever was the most observed symptom, lasting 4-6 days in 55.9% (n=33) of cases, followed by ≤3 days in 38.3% (n=23) cases and ≥7 days in 5% (n=3) cases. Abdominal pain and vomiting were observed in 76.6% (n=46) of patients, and shock was observed in 61.6% (n=37) of patients. Shock was observed in 60% (n=36) of patients, pleural effusion in 45% (n=27), ascites in 33.3% (n=20), and hepatomegaly in 20% (n=12) cases. Rash was observed in 18.3% (n=11) of patients, while loose motions and difficulty breathing were observed in 15% (n=9) of cases each. Headache was present in 10% (n=6) of cases, and myalgia and arthralgia were observed in 8.3% (n=5) of cases. Convulsion and altered consciousness were rare presentations seen in 6.6% (n=4) of cases and 5% (n=3) of cases, respectively. Conclusion: Severe dengue is characterized by nausea, vomiting, shock, ascites, and pleural effusion. Important findings in patients with severe disease include elevated AST and D-dimer levels, low fibrinogen and albumin levels, and hyponatremia. With prompt diagnosis and appropriate treatment, its severity can be reduced.