Rao Pooja, Basavaprabhu Achappa, Shenoy Suchitra, Dsouza Nikhil Victor, Sridevi Hanaganahalli Basavaiah, Kulkarni Vaman
Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka-575001, India.
Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
Int J Microbiol. 2020 Dec 15;2020:6658445. doi: 10.1155/2020/6658445. eCollection 2020.
Dengue fever, being hyperendemic with analogous presentations as in many other acute febrile illnesses, poses a challenge in diagnosis during the acute stage. Additionally, the coexistence of multiple serotypes further complicates the disease prognosis. The study was undertaken to determine the dengue virus serotypes, clinical, and laboratory markers as predictors in the severity of infection.
A prospective study was conducted among 106 patients admitted with acute febrile illness having positive NS1 antigen/IgM ELISA. Clinical data were extracted from medical records including demographics, presence of comorbid conditions, clinical presentation, laboratory investigations, and course including length of hospital stay and outcome. Detection of dengue serotypes was done by multiplex reverse transcriptase polymerase chain reaction (RT_PCR).
Out of 106 RT-PCR-confirmed cases, DENV-3 was the most common serotype found in 56 (52.8%) patients, followed by DENV-3 and DENV-4 coinfection in 27 (25.4%) patients. Coinfection with more than one serotype was witnessed in our study. Raised liver enzymes and increased ferritin are good biomarkers in differentiating dengue from severe dengue with cutoff levels for AST (134 U/L), ALT (88 U/L), and ferritin (3670 ng/ml). Musculoskeletal, followed by gastrointestinal, manifestations were comparatively higher than respiratory and cutaneous manifestations.
This study provides more information on the dengue serotypes. The clinical spectrum along with laboratory parameters such as ferritin, liver enzymes, platelet can be used as potential biomarkers in prediction of dengue severity. The data demonstrated will be useful in early detection and monitoring of the disease.
登革热在许多其他急性发热性疾病中呈高度地方性流行且临床表现相似，在急性期诊断方面构成挑战。此外，多种血清型共存使疾病预后更加复杂。本研究旨在确定登革病毒血清型、临床和实验室指标作为感染严重程度的预测因素。
对106例NS1抗原/IgM ELISA检测呈阳性的急性发热性疾病患者进行了一项前瞻性研究。从病历中提取临床数据，包括人口统计学资料、合并症情况、临床表现、实验室检查以及病程，包括住院时间和结局。通过多重逆转录聚合酶链反应（RT_PCR）检测登革热血清型。
在106例经RT-PCR确诊的病例中，DENV-3是最常见的血清型，在56例（52.8%）患者中发现，其次是27例（25.4%）患者同时感染DENV-3和DENV-4。本研究中观察到了多种血清型的合并感染。肝酶升高和铁蛋白增加是区分登革热和重症登革热的良好生物标志物，AST（134 U/L）、ALT（88 U/L）和铁蛋白（3670 ng/ml）有临界值。肌肉骨骼表现，其次是胃肠道表现，相对高于呼吸道和皮肤表现。
本研究提供了关于登革热血清型的更多信息。临床症状以及铁蛋白、肝酶、血小板等实验室参数可作为预测登革热严重程度的潜在生物标志物。所展示的数据将有助于疾病的早期检测和监测。
