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印度钦奈2011年至2018年发热病例的临床特征及非典型表现

Clinical profile and atypical manifestation of fever cases between 2011 and 2018 in Chennai, India.

作者信息

Mohan Kamalraj, Malaiyan Jeevan, Nasimuddin Sowmya, Devasir Ravin Sathyaseelan, Meenakshi-Sundaram PradeepRaj, Selvaraj Santhiya, Krishnasamy Bharathi, Gnanadesikan Sumathi, Karthikeyan Muthulakshmi, Kandasamy Mohanakrishnan, Jayakumar Nithyalakshmi, Elumalai Dhevahi, Ra Gokul G

机构信息

Department of Microbiology, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India.

Department of General Medicine, Sri Muthukumaran Medical College Hospital and Research Institute, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chikkarayapuram, Chennai, Tamil Nadu, India.

出版信息

J Family Med Prim Care. 2020 Feb 28;9(2):1119-1123. doi: 10.4103/jfmpc.jfmpc_926_19. eCollection 2020 Feb.

Abstract

INTRODUCTION

Dengue fever is a common mosquito-borne viral disease which has reached alarming size in the past few years. It is endemic in more than 100 countries and significant differences were found in clinical profile and atypical manifestation.

AIM OF THE STUDY

A retrospective observational study of clinical profile and atypical manifestations in patients with dengue fever.

MATERIALS AND METHODS

Serum samples were collected from clinically suspected cases of dengue fever and it was confirmed by NS1 antigen, IgM, and IgG antibody by ELISA. Clinical details and atypical manifestations were recorded.

OBSERVATION

During the study period, a total of 2502 patients were suspected to have dengue infection, of which 464 (18.5%) samples were found to be positive for dengue viral infection. A majority of the cases were males [268 (57%)] when compared with females [196 (42%)]. Fever was the most common clinical presentation seen in all the patients, followed by headache (78.4%), myalgia (61%), body pain (49.3%), vomiting (40%), joint pain (31.5%), dry cough (19%), nausea (14%), abdominal pain (8%), diarrhea (5.6%), retro-orbital pain (04%), burning micturition (2.4%), and rashes (0.6%). Among atypical manifestations, hepatomegaly [32 (7%)] was the most common, followed by splenomegaly [23 (5%)], bradycardia [18 (4%)], meningitis [6 (1.2%)], hemoptysis [5 (1%)], acalculous cholecystitis [4 (0.8%)], and acute pancreatitis [2 (0.4%)]. The study of hematological parameters showed thrombocytopenia was present in 179 (38.5%) patients, followed by leukopenia [77 (17%)] and raised hematocrit [29 (6.2%)].

CONCLUSION

During ongoing epidemics, the clinical profile and atypical manifestations in clinically suspected dengue patients should be investigated early so that severe forms can be treated promptly.

摘要

引言

登革热是一种常见的蚊媒病毒性疾病,在过去几年中已达到惊人的规模。它在100多个国家流行,并且在临床特征和非典型表现方面存在显著差异。

研究目的

对登革热患者的临床特征和非典型表现进行回顾性观察研究。

材料与方法

从临床疑似登革热病例中采集血清样本,并通过酶联免疫吸附测定法(ELISA)检测NS1抗原、IgM和IgG抗体以进行确诊。记录临床细节和非典型表现。

观察结果

在研究期间,共有2502例患者疑似感染登革热,其中464例(18.5%)样本被发现登革病毒感染呈阳性。与女性[196例(42%)]相比,大多数病例为男性[268例(57%)]。发热是所有患者中最常见的临床表现,其次是头痛(78.4%)、肌痛(61%)、全身疼痛(49.3%)、呕吐(40%)、关节疼痛(31.5%)、干咳(19%)、恶心(14%)、腹痛(8%)、腹泻(5.6%)、眼眶后疼痛(4%)、尿痛(2.4%)和皮疹(0.6%)。在非典型表现中,肝肿大[32例(7%)]最为常见,其次是脾肿大[23例(5%)]、心动过缓[18例(4%)]、脑膜炎[6例(1.2%)]、咯血[5例(1%)]、非结石性胆囊炎[4例(0.8%)]和急性胰腺炎[2例(0.4%)]。血液学参数研究显示,179例(38.5%)患者存在血小板减少,其次是白细胞减少[77例(17%)]和血细胞比容升高[29例(6.2%)]。

结论

在持续的疫情期间,应尽早调查临床疑似登革热患者的临床特征和非典型表现,以便能及时治疗严重病例。

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