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Ultrasonography as a tool in predicting the severity of dengue fever in children—a useful aid in a developing country

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Abstract

Background

Dengue fever accounts for significant mortality in developing countries. Dengue fever serology takes a week at least to be reported positive, thus necessitating the need for other markers of diagnosis and prognosis.

Objective

The purpose of this study was to investigate the role of ultrasonography as a tool in diagnosing and predicting the severity of dengue fever in children.

Materials and methods

This was a prospective study conducted in a tertiary pediatric centre from September 2010 to July 2012. Three hundred twenty-four children with confirmed dengue fever were compared with 422 children of suspected dengue fever. Severity of illness was graded as per WHO criteria and sonography findings were correlated to the grade of illness.

Results

Gallbladder wall thickening was seen in 75% of the children with confirmed dengue fever. A significant difference was seen between survivors and non-survivors with respect to pericholecystic fluid collection (P = 0.002), hepatic intraparenchymal fluid (P < 0.001), splenomegaly (P = 0.002), splenic subcapsular fluid (P < 0.001), peripancreatic fluid (P < 0.001), perirenal fluid (P < 0.001) and pericardial fluid (P < 0.001). Other findings included ascites, pleural effusion, hepatomegaly and splenomegaly, which were present irrespective of grade of illness.

Conclusions

Ultrasonography can be used as a useful tool in developing countries to predict the severity of dengue fever in children.

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References

  1. World Health Organization (1997) Dengue haemorrhagic fever: diagnosis, treatment, prevention, and control, 2nd edn. World Health Organization, Geneva

    Google Scholar 

  2. Rahman M, Rahman K, Siddique AK et al (2002) First outbreak of dengue haemorrhagic fever, Bangladesh. Emerg Infect 8:738–740

    Article  Google Scholar 

  3. Sai PMV, Dev B, Krishnan R (2005) Role of ultrasound in dengue fever. Br J Radiol 78:416–418

    Article  Google Scholar 

  4. Setiawan MW, Samsi TK, Wulur H et al (1998) Dengue haemorrhagic fever: ultrasound as an aid to predict the severity of the disease. Pediatr Radiol 28:1–4

    Article  PubMed  CAS  Google Scholar 

  5. Wu KL, Changchien CS, Kuo CH et al (2004) Early abdominal sonographic findings in patients with dengue fever. Clin Ultrasound 32:386–388

    Article  Google Scholar 

  6. Thulkar S, Sharma S, Srivastava DN et al (2000) Sonographic findings in grade III dengue hemorrhagic fever in adults. J Clin Ultrasound 28:34–37

    Article  PubMed  CAS  Google Scholar 

  7. Pramuljo HS, Harun SR (1991) Ultrasound findings in dengue haemorrhage fever. Pediatr Radiol J 21:100–102

    Article  CAS  Google Scholar 

  8. Venkata S, Dev B, Krishnan R (2005) Role of ultrasound in dengue fever. Br J Radiol 78:416–418

    Article  Google Scholar 

  9. Setiawan MW, Samsi TK, Pool TN et al (1995) Gallbladder wall thickening in dengue hemorrhagic fever: an ultrasonographic study. J Clin Ultrasound 23:357–362

    Article  PubMed  CAS  Google Scholar 

  10. Quiroz-Moreno R, Mendez GF, Ovando-Rivera KM (2006) Clinical utility of ultrasound in the identification of dengue hemorrhagic fever. Rev Med Inst Mex Seguro Soc 44:243–248

    PubMed  Google Scholar 

  11. Srikiatkhachorn A, Krautrachue A, Ratanaprakarn W et al (2007) Natural history of plasma leakage in dengue hemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J 26:283–292

    Article  PubMed  Google Scholar 

  12. Colbert JA, Gordon A, Roxelin R et al (2007) Ultrasound measurement of gallbladder wall thickening as a diagnostic test and prognostic indicator for severe dengue in pediatric patients. Pediatr Infect Dis J 26:850–852

    Article  PubMed  Google Scholar 

  13. Lei HY, Yeh TM, Liu HS et al (2001) Immunopathogenesis of dengue virus infection. J Biomed Sci 8:377–388

    Article  PubMed  CAS  Google Scholar 

  14. Joshi P, Rathnam VG, Sharma S (1997) USG findings in dengue haemorrhagic fever—our experience in the recent epidemic. Ind J Radiol Imag 7:189–192

    Google Scholar 

  15. Mia MW, Nurullah AM, Hossain A et al (2010) Clinical and sonographic evaluation of dengue fever in Bangladesh: a study of 100 cases. Dinajpur Med Col J 3:29–34

    Google Scholar 

  16. Setiawan MW, Samsi TK, Pool TN et al (1995) Early diagnosis of dengue haemorrhagic fever. Ultrasound Int 1:140

    Google Scholar 

  17. Halstead SB (1982) Dengue: hematologic aspects. Semin Hematol 19:116

    PubMed  CAS  Google Scholar 

  18. Guzman MG, Kouri G, Valdes L et al (2000) Epidemiologic studies on dengue in Santiago de Cuba, 1997. Am J Epidemiol 152:793–799

    Article  PubMed  CAS  Google Scholar 

  19. Halstead SB, Heinz FX (2005) Dengue virus: molecular basis of cell entry and pathogenesis. Vaccine 23:849–856

    Article  PubMed  Google Scholar 

  20. Bhamarapravati N, Tuchinda P, Boonyapaknavik V (1967) Pathology of Thailand haemorrhagic fever: a study of 100 autopsy cases. Ann Trop Med Parasitol 61:500–510

    PubMed  CAS  Google Scholar 

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Correspondence to K. R. Bharath Kumar Reddy.

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Bharath Kumar Reddy, K.R., Laksmana, R.R., Veerappa, B.G. et al. Ultrasonography as a tool in predicting the severity of dengue fever in children—a useful aid in a developing country. Pediatr Radiol 43, 971–977 (2013). https://doi.org/10.1007/s00247-013-2642-0

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  • DOI: https://doi.org/10.1007/s00247-013-2642-0

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