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
World Health Organization (1997) Dengue haemorrhagic fever: diagnosis, treatment, prevention, and control, 2nd edn. World Health Organization, Geneva
Rahman M, Rahman K, Siddique AK et al (2002) First outbreak of dengue haemorrhagic fever, Bangladesh. Emerg Infect 8:738–740
Sai PMV, Dev B, Krishnan R (2005) Role of ultrasound in dengue fever. Br J Radiol 78:416–418
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
Wu KL, Changchien CS, Kuo CH et al (2004) Early abdominal sonographic findings in patients with dengue fever. Clin Ultrasound 32:386–388
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
Pramuljo HS, Harun SR (1991) Ultrasound findings in dengue haemorrhage fever. Pediatr Radiol J 21:100–102
Venkata S, Dev B, Krishnan R (2005) Role of ultrasound in dengue fever. Br J Radiol 78:416–418
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
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
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
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
Lei HY, Yeh TM, Liu HS et al (2001) Immunopathogenesis of dengue virus infection. J Biomed Sci 8:377–388
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
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
Setiawan MW, Samsi TK, Pool TN et al (1995) Early diagnosis of dengue haemorrhagic fever. Ultrasound Int 1:140
Halstead SB (1982) Dengue: hematologic aspects. Semin Hematol 19:116
Guzman MG, Kouri G, Valdes L et al (2000) Epidemiologic studies on dengue in Santiago de Cuba, 1997. Am J Epidemiol 152:793–799
Halstead SB, Heinz FX (2005) Dengue virus: molecular basis of cell entry and pathogenesis. Vaccine 23:849–856
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
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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