Alam Anggraini, Andriyani Fina Meilyana, Peryoga Stanza Uga
Infection & Tropical Diseases Division, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin General Hospital, Bandung, Indonesia.
Emergency and Intensive Care Division, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin General Hospital, Bandung, Indonesia.
Int J Emerg Med. 2024 Jul 11;17(1):85. doi: 10.1186/s12245-024-00658-6.
Severe multisystem inflammatory syndrome in children (MIS-C) and severe dengue are challenging to identify during the COVID-19 pandemic in dengue-endemic areas. Fever, multiorgan involvement, and shock characterize both severe MIS-C and severe dengue. Distinguishing between the two diseases is beneficial in initiating proper management.
Medical records of children < 18 years old who were hospitalized at Hasan Sadikin General Hospital's PICU between December 2020 and July 2022 with severe MIS-C or severe dengue were recorded. Differences were assessed using comparative and descriptive analyses.
Seventeen severe dengue patients and 4 severe MIS-C were included. The average age of severe MIS-C was 11.5 years (SD ± 2.9, 95% CI), and that of severe dengue patients was 6.2 years (SD ± 4.4, 95% CI) (p value = 0.034, 95%). Fever and abdominal pain were the most common symptoms in both groups (p = 0.471, 95% CI). Rash (p = 0.049) and nonpurulent conjunctivitis (p = 0.035) were two symptoms with significant differences. The highest platelet count (p-value = 0.006, 95% CI), AST (p-value = 0.026, 95% CI), and D-dimer level (p-value = 0.025, 95% CI) were significantly different between the two cohorts. Cardiac abnormalities were found in all (100%) severe MIS-C patients, but only one (5.9%) in severe dengue patients.
Age, rash, nonpurulent conjunctivitis, platelet count, AST and D-dimer level may distinguish severe MIS-C from severe dengue fever.
在登革热流行地区的新冠疫情期间，儿童严重多系统炎症综合征（MIS-C）和严重登革热难以鉴别。严重MIS-C和严重登革热均以发热、多器官受累及休克为特征。区分这两种疾病有助于开展恰当的治疗。
记录2020年12月至2022年7月期间在哈桑·萨迪金综合医院儿科重症监护病房住院的18岁以下患有严重MIS-C或严重登革热的儿童的病历。采用比较分析和描述性分析评估差异。
纳入17例严重登革热患者和4例严重MIS-C患者。严重MIS-C患者的平均年龄为11.5岁（标准差±2.9，95%置信区间），严重登革热患者的平均年龄为6.2岁（标准差±4.4，95%置信区间）（p值 = 0.034，95%）。发热和腹痛是两组最常见的症状（p = 0.471，95%置信区间）。皮疹（p = 0.049）和非脓性结膜炎（p = 0.035）是两种有显著差异的症状。两组之间最高血小板计数（p值 = 0.006，95%置信区间）、谷草转氨酶（p值 = 0.026，95%置信区间）和D-二聚体水平（p值 = 0.025，95%置信区间）有显著差异。所有（100%）严重MIS-C患者均发现心脏异常，而严重登革热患者中只有1例（5.9%）有心脏异常。
年龄、皮疹、非脓性结膜炎、血小板计数、谷草转氨酶和D-二聚体水平可能有助于区分严重MIS-C和严重登革热。
