Ultrasound as screening modality in management of fever cases in dengue epidemic: Study of 202 cases
Article Sidebar
Views | PDF/EPUB Downloads:
65
/ 5
/ 6
Main Article Content
Abstract
Aims and Background: Ultrasound is a screening procedure in suspected dengue fevers (DFs) and other febrile illness in epidemic areas with limited laboratory resources to help in prioritizing patients for emergency critical care. DF has become epidemic in India. Symptomatic dengue infection with any of the four serotypes of dengue virus can produce systemic and dynamic disease with a broad spectrum of illness with severe and nonsevere clinical manifestations.
Subjects and Methods: A retrospective record-based study of 202 cases of suspected DFs were evaluated by ultrasound for a period of 18 months during epidemic in Radiology Department. All age groups were included in the study. Ultrasound of abdomen and chest performed in between 3rd and 10th day of fever. The data compiled by incorporating sonographic findings, clinical findings, and laboratory results. Laboratory data include serology and platelet count.
Results: Ultrasound findings were analyzed, in comparison with clinical detection and laboratory results. Eighty-five percent were pediatric age group. The triad of ultrasound findings is stratified gallbladder wall thickening, 85.2%; ascites, 78%; and pleural effusions, 67.8%. Others are pericardial effusion 2.5%, hepatomegaly 9.1%, and splenomegaly 6.1%. Nearly 18.8% of severe dengue cases were observed. Detection of capillary leakage was 100% on ultrasound and 39.70% on thrombocytopenia. Eighty-six serology positive,
107 with no serology, and 6 seronegative cases were positive for ultrasound. Fifty-five percent isolated gallbladder edema is seen before thrombocytopenia.
Conclusion: Ultrasound can be utilized as the mainstay of investigation in epidemic regions with infrastructure shortage. Early demonstration of serosal collection helps to grade DF to severe dengue and prioritize patients for critical care.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
How to Cite
References
1. Hammond SN, Balmaseda A, Pérez L, Tellez Y, Saborío SI, Mercado JC, et al. Differences in dengue severity in infants, children, and adults in a 3‑year hospital‑based study in Nicaragua. Am J Trop Med Hyg 2005;73:1063‑70.
2. WHO. Handbook for Clinical Management of Dengue. Geneva: WHO; 2012. p. 2‑81.
3. World Health Organization. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. A Joint Publication of the World Health Organization and the Special Program for Research and Training in Tropical Diseases. Available from: http://www.who. int/csr/resources/publications/dengue9789241547871/en/index. html. [Last accessed on 2012 Jun 18].
4. Setiati TE, Mairuhu AT, Koraka P, Supriatna M, Mac Gillavry MR, Brandjes DP, et al. Dengue disease severity in Indonesian children: An evaluation of the World Health Organization classification system. BMC Infect Dis 2007;7:22.
5. Colbert JA. Assessing the Role of Ultrasound to Determine Prognosis and Disease Severity in Paediatric Dengue Patients. Stanford University
School of Medicine Travelling Medical Scholars Proposal: Clinical Research Concentration. Available from: http://med.stanford.edu/
oih/documents/Colbert-TravelScholarProposal.doc.
6. Balasubramanian S, Janakiraman L, Kumar SS, Muralinath S, Shivbalan S. A reappraisal of the criteria to diagnose plasma leakage in dengue hemorrhagic fever. Indian Pediatr 2006;43:334‑9.
7. Setiawan MW, Samsi TK, Wulur H, Sugianto D, Pool TN. Dengue haemorrhagic fever: Ultrasound as an aid to predict the severity of the disease. Pediatr Radiol 1998;28:1‑4.
8. Nimmannitya S. Clinical spectrum and management of dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health 1987;18:392‑7.
9. Murray NE, Quam MB, Wilder‑Smith A. Epidemiology of dengue: Past, present and future prospects. Clin Epidemiol 2013;5:299‑309.
10. Dengue Virus Infections 2015 Case Definition -CDC. Available from: https://wwwn.cdc.gov/nndss/conditions/dengue-virus-infections/
case-definition/2015/.
11. Ministry of Health. National guidelines on management of dengue fever and hemorrhagic fever in adults and children. Colombo: Ministry of Health, Sri Lanka; 2011.
12. Nair BT, Sanjeev RK, Mishra A. Dengue epidemic management in a developing country. Int J Med Public Health 2015;5:213‑6.
13. Venkata Sai PM, Dev B, Krishnan R. Role of ultrasound in dengue fever. Br J Radiol 2005;78:416‑8.
14. Srikiatkhachorn A, Krautrachue A, Ratanaprakarn W, Wongtapradit L, Nithipanya N, Kalayanarooj S, et al. Natural history of plasma leakage
in dengue hemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J 2007;26:283‑90.
15. Thulkar S, Sharma S, Srivastava DN, Sharma SK, Berry M, Pandey RM. Sonographic findings in grade III dengue hemorrhagic fever in adults. J Clin Ultrasound 2000;28:34‑7.
16. Agrawal P, Garg R, Srivastava S, Verma U, Rani R. Pregnancy outcome in women with dengue infection in Northern India. Int J Clin Pract
2014;24:1053‑6.
17. Chandak S, Kumar A. Can radiology play a role in early diagnosis of dengue fever? N Am J Med Sci 2016;8:100‑5.