Abstract
Background: The changing epidemiology of dengue fevers in terms of strains, severity and geographic distribution is raising concern in India. Dengue virus infection, the most common and widespread arthropod-borne viral infection has grown dramatically in the last 50 years globally. Most commonly adults are affected by dengue, but the pediatric population is more vulnerable.
Method: A hospital-based study was conducted for a period of 2 months (June –July 2019) among 134 cases of dengue fever between the age group of 3 months to 15 years presenting with symptoms & signs suggestive of dengue fever as per WHO criteria were recorded and were analyzed in detail with more emphasis on onset of skin lesions, their morphology, distribution, sites involved and progression in study area.
Results: About 134 patients with dengue fever were enrolled, 70.1 % were males and 29.9 % were females. Cutaneous manifestations were present in 50.7% of patients while mucous manifestation was seen in 8.9% of patients. Bleeding manifestations were seen in 28.4% of cases with petechiae (26.3%) was the commonest manifestation.
Conclusion: Though dengue is a systemic illness, more than half of the patients showed cutaneous involvement and 50% of patients had an onset of skin rash consistently with fever which can help in suspecting dengue illness. Thus skin can be involved in various ways in children with dengue fever and can help diagnose the illness clinically, especially in places with inadequate laboratory support.
Keywords: Dermatological manifestations, Dengue fever, Pediatric age group.
References
- Khan E, Hasan R. dengue infection in Asia; A Regional concern, Editorial. J Post Graduate Med Inst 2012; 20(1);1-6.
- Dengue and severe dengue. https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue [online Accessed on August 20 2019]
- Omar L, Gustavo CC, Branco CIC. Mucocutaneous manifestations of dengue. An Bras Dermatol. 2007; 82: 291-305.
- Lee LK, Thein TL, Kurukularatne C, Gan VCH, Lye DC, Leo YS. Dengue Knowledge, Attitudes, and Practices among Primary Care Physicians in Singapore. Ann Acad Med Singapore 2011;40:533-38.
- A. Seetharam, IADVL Textbook of Dermatology, fourth edition 2015, vol-1; 612-14.
- Thomas EA, John M, Bhatia A. Cutaneous manifestation of dengue viral infection in Punjab (North India). Int J Dermatol. 2007; 46: 715-19.
- World Health Organization. Comprehensive guidelines for prevention and control of Dengue and dengue hemorrhagic fever. http://apps.searo.who.int/pds_docs/B4751.pdf [Accessed on 25 August 2019]
- Narayanan M, Arvind MA, Thilothammal N, Prema R, Sargunam Rex CS et al. Dengue fever epidemic in Chennai – A study of clinical profile and outcome. Indian Pediatr 2002;39:1027-33.
- Mahmood K, Jameel T, Aslam HF, Tahir M. Incidence of dengue hemorrhagic fever in the local population of Lahore, Pakistan. Biomedica 2009;25:93-96.
- Pothapregada S, Kamalakannan B, Thulasingham M, Sampath S. Clinically profiling pediatric patients with dengue. J Global Infect Dis 2016; 8:115-20.
- Gurdeep SD, Deepak B, Harmesh SB. Clinical profile and outcome of children of dengue hemorrhagic fever in North India. Iran J Pediatr 2008; 18:222-28.
- Teixeira MG, Barreto ML, Costal MCN, Denize L, Ferreira A, Vasoconcelos PFC et a. Dynamics of dengue virus circulation: a silent epidemic in a complex urban area. Trop Med Int Health 2002;7:757-62.
- EA Henchal, JR Putnak. The Dengue Viruses. Clin Microbiol Rev 1990; 3(4): 376–96.
- Ahmed, F. Arif, Y. Yahya et al; Dengue fever outbreak in Karachi2006 a study of profile and outcome of children under 15 years of age, Journal of the Pakistan Medical Association 2008; 58(1):4–8.
- SPW Kumarasinghel, AMSD Eriyagama, W Gunathileke, KPP Wijesuriyaa, L De Silva. Cutaneous manifestations of dengue fever. Sri Lanka Journal of Dermatology 2009;1(3):10-74.
- Gomber S, Ramachandran VG, Kumar S, Agarwal, Gupta P, Gupta P et al. Hematological observations as diagnostic markers in dengue hemorrhagic fever a reappraisal. Indian Pediatr 2001;38:477-81.
- Reddy GC, Nagendra K. Clinical and diagnostic features of dengue hemorrhagic fever in children. Int J Contemp Pediatr 2018;5(3):791-97.
- Rachel Daniel, Raja Mohan, Aby Zachariah Philip. A Study of Clinical Profile of Dengue Fever in Kollam, Kerala, India. Dengue Bulletin 2005; Vol 29: 197-202.
- Narayan M, Aravind MA, Thilothammal N, et al. Dengue fever epidemic in Chennai: a clinical profile and outcome. Indian Pediatrics. 2002; 39: 1027-33.
- Faridi MMA, Aggarwal A, Kumar M, Sarafrazul A. Clinical and biochemical profile of dengue haemorrhagic fever in children in Delhi. Trop Doct. 2008;38 (1):28–30.
- Kumar R, Tripathi P, Tripathi S, Alokkanodia, VimalaVenkatesh. Prevalence of dengue infection in North Indian children with acute hepatic failure. Ann Hepatol. 2008;7:59-62.
Corresponding Author
Dr Ramesh Rachakonda
Rachaconda Skin and Mind Clinic, H. No.6-6-444, Near SBI Bank, Choppadandi Road, Karimnagar-505001 Telangana State, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i10.67
