ATYPICAL MANIFESTATIONS OF DENGUE FEVER DURING AN OUTBREAK IN A TERTIARY CARE HOSPITAL OF WESTERN UTTAR PRADESH (NORTH INDIA)
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Keywords
Dengue, acalculous cholecystitis
Abstract
Introduction: Dengue is a rapidly emerging global health problem. It has variable clinical presentation with many atypical presentations, thus posing a diagnostic challenge for the physician.
Objective: To study the clinical profile of dengue infection during an outbreak in July-November, 2012 in a tertiary care teaching hospital of western UP.
Material and methods: A prospective, observational, single centre study was carried out on patients of dengue fever who were admitted to the medicine ward of Santosh Medical College Hospital, affiliated to Santosh University, Ghaziabad (UP).
Results: 120 patients were diagnosed as dengue fever based on the presence of NS1 antigen and /or dengue IgM in blood samples. The common signs and symptoms were fever (100%), headache ( 81.6%), myalgia (55%), retro-orbital pain (51.6%) and abdominal pain ( 45%). Among the atypical presentations, hepatitis (43.3%) was the most common followed by acalculous cholecystitis (32%), bradycardia (23.3%), febrile diarrhoea (15%), meningoencephalitis (1.6%) , pancreatitis (1.6%).
Conclusion: Dengue infection in India has evolved rapidly, and regular outbreaks have been observed with a changing epidemiology, as the disease is rapidly spreading from urban to rural areas with increasing atypical manifestations.
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Anurag Prasad
Associate Professor, Department of Medicine, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
Tapas Tripathi
Resident, Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India