A Tejashree, S Chinchana E, Badveti Satyasai, Vs Krishna Karthik M, Kumar Vinay, S Veerabhadra Swamy G
Microbiology, JSS (Jagadguru Sri Shivarathreeshwara) Medical College and Hospital, JSS Academy of Higher Education, Mysuru, IND.
Microbiology, Gayatri Vidya Parishad Institute of Healthcare and Medical Technology, Visakhapatnam, IND.
Cureus. 2024 Jul 23;16(7):e65175. doi: 10.7759/cureus.65175. eCollection 2024 Jul.
Introduction Dengue, a viral infection transmitted by mosquitoes, has become a significant global health concern. Its incidence has surged dramatically over the past decades, with severe cases potentially leading to life-threatening conditions such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Despite its prevalence in tropical regions, including India, the clinical manifestations of dengue can vary widely, sometimes presenting atypically. Recent outbreaks, particularly in Northern India, underscore the urgency of understanding and managing this disease. This study focuses on the clinical and laboratory findings of hospitalized dengue fever patients from January 2022 to January 2023, aiming to provide insights for effective patient care and mortality reduction. Methods This was a prospective study at JSS (Jagadguru Sri Shivarathreeshwara) Medical College and Hospital, Mysuru, Karnataka, India (January 2022-January 2023). Blood samples from suspected dengue patients presenting acute febrile symptoms were collected. NS1 antigen and IgM antibody were detected using enzyme-linked immunosorbent assay (ELISA). Patients positive for dengue NS1 antigen and IgM antibodies were included in the study, excluding those with co-infections or comorbidities. Results A nine-month study at JSS Hospital (January 2022-January 2023) screened 1019 samples, identifying 316 dengue cases. Among these, 84.8% were dengue fever and 15.1% were DHF/DSS. Male predominance (60.1%) was noted, with peak incidence in the age groups of 11-20 years (29.11%) and 0-10 years (27.53%). Common symptoms included fever (98.1%), headache (32.91%), myalgia (40.87%), and vomiting (42.7%). Thrombocytopenia was found in 60.6% of cases. NS1 was detected in 56% of patients and IgM was positive in 20.8% of the patients. Comorbidities like type 2 diabetes mellitus (T2DM) (7.59%) and hypertension (7.27%) were observed. Among severe cases, 43.6% had platelet counts <1 lakh/cumm, and 27.5% required intravenous fluids. Seven deaths occurred, primarily in patients with comorbidities and severe dengue. Discussion and conclusion High dengue seropositivity among males (60.12%) compared to females (39.87%) was noted, possibly due to varied exposures. Patients aged 11-20 years had the highest dengue infection, with a peak in admissions during the rainy season. Thrombocytopenia (60.6%) and comorbidities like T2DM and HTN were common, with seven fatalities linked to severe dengue and comorbidities, emphasizing the need for early recognition and management to reduce mortality.
引言
登革热是一种由蚊子传播的病毒感染疾病,已成为全球重大的健康问题。在过去几十年中,其发病率急剧上升,严重病例可能导致危及生命的状况,如登革出血热(DHF)和登革休克综合征(DSS)。尽管登革热在包括印度在内的热带地区普遍存在,但其临床表现可能差异很大,有时呈现非典型症状。近期的疫情爆发,特别是在印度北部,凸显了了解和管理这种疾病的紧迫性。本研究聚焦于2022年1月至2023年1月期间住院登革热患者的临床和实验室检查结果,旨在为有效的患者护理和降低死亡率提供见解。
方法
这是一项在印度卡纳塔克邦迈索尔市贾格德古鲁·斯里·希瓦拉特里什瓦拉医学院和医院进行的前瞻性研究(2022年1月至2023年1月)。收集了出现急性发热症状的疑似登革热患者的血样。使用酶联免疫吸附测定(ELISA)检测NS1抗原和IgM抗体。登革热NS1抗原和IgM抗体呈阳性的患者被纳入研究,排除合并感染或合并症患者。
结果
在贾格德古鲁·斯里·希瓦拉特里什瓦拉医学院和医院进行的为期九个月的研究(2022年1月至2023年1月)中,筛查了1019份样本,确定了316例登革热病例。其中,84.8%为登革热,15.1%为登革出血热/登革休克综合征。男性占优势(60.1%),发病高峰在11 - 20岁年龄组(29.11%)和0 - 10岁年龄组(27.53%)。常见症状包括发热(98.1%)、头痛(32.91%)、肌痛(40.87%)和呕吐(42.7%)。60.6%的病例出现血小板减少。56%的患者检测到NS1,20.8%的患者IgM呈阳性。观察到合并症,如2型糖尿病(T2DM)(7.59%)和高血压(7.27%)。在重症病例中,43.6%的患者血小板计数<10万/立方毫米,27.5%的患者需要静脉输液。发生了7例死亡,主要发生在合并症患者和重症登革热患者中。
讨论与结论
注意到男性登革热血清阳性率(60.12%)高于女性(39.87%),这可能是由于不同的接触情况。11 - 20岁的患者登革热感染率最高,雨季入院人数达到峰值。血小板减少(60.6%)以及T2DM和高血压等合并症很常见,7例死亡与重症登革热和合并症有关,强调需要早期识别和管理以降低死亡率。