Department of Microbiology, University of Health Sciences, Lahore, Pakistan.
Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan.
Am J Trop Med Hyg. 2023 Oct 23;109(6):1284-1289. doi: 10.4269/ajtmh.23-0309. Print 2023 Dec 6.
The global burden of dengue infections has increased dramatically. Early diagnosis of dengue infection is critical to proper medical management to avoid further complications in patients. This study was geared to assess the severity of dengue infections based on clinical and hematological examinations. A cross-sectional study was conducted among febrile patients with dengue infection in a teaching hospital in Pakistan. Blood samples were investigated for dengue-specific antibodies (IgM and IgG) and the nonstructural 1 antigen. The clinical findings of each subject were noted to assess the severity of the infection. Tests for hematological parameters were performed. Of 130 patients with confirmed dengue infection, 23 had severe and 107 had nonsevere dengue. Patients with severe dengue experienced mucosal bleeding (71.4%), fluid accumulation (57.1%), shock (35.7%), and gastrointestinal bleeding (28.6%). The most significant hematological findings among severe and nonsevere patients with dengue infection were thrombocytopenia, leukopenia, and a raised hematocrit level (P < 0.001). Patients with severe dengue infection showed marked thrombocytopenia, with a mean platelet count of 49.96 × 109 platelets/L. The clinical presentation of patients with dengue infection along with hematological markers are the most important clues for the diagnosis of, prognosis of, and therapy for dengue infection. Thrombocytopenia, leukopenia, and raised hematocrit levels were the most significant hematological parameters when assessing the severity of dengue infection.
全球登革热感染负担显著增加。及早诊断登革热感染对患者进行适当的医疗管理至关重要，以避免进一步的并发症。本研究旨在根据临床和血液检查评估登革热感染的严重程度。在巴基斯坦的一家教学医院对登革热感染的发热患者进行了横断面研究。对血液样本进行了登革热特异性抗体（IgM 和 IgG）和非结构蛋白 1 抗原检测。记录每个患者的临床发现，以评估感染的严重程度。进行了血液学参数的检测。在 130 例确诊的登革热感染患者中，23 例为重症，107 例为非重症。重症登革热患者出现黏膜出血（71.4%）、体液积聚（57.1%）、休克（35.7%）和胃肠道出血（28.6%）。重症和非重症登革热感染患者最显著的血液学发现是血小板减少、白细胞减少和血细胞比容升高（P<0.001）。重症登革热感染患者的血小板明显减少，平均血小板计数为 49.96×109 个血小板/L。登革热感染患者的临床表现和血液学标志物是诊断、预后和治疗登革热感染的最重要线索。血小板减少、白细胞减少和血细胞比容升高是评估登革热感染严重程度的最显著血液学参数。
