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小儿登革热的临床和实验室特征及治疗结果

Clinical and Laboratory Features and Treatment Outcomes of Dengue Fever in Pediatric Cases.

作者信息

Nusrat Nadia, Chowdhury Kona, Sinha Susmita, Mehta Miral, Kumar Santosh, Haque Mainul

机构信息

Department of Pediatrics, Delta Medical College and Hospital, Dhaka, BGD.

Department of Pediatrics, Enam Medical College and Hospital, Dhaka, BGD.

出版信息

Cureus. 2024 Dec 16;16(12):e75840. doi: 10.7759/cureus.75840. eCollection 2024 Dec.

Abstract

Background Globally, dengue fever (DF) is the leading cause of arthropod-borne viral illness, which considerably contributes to an atrocious death rate. The disease is now endemic in some parts of the world, including Bangladesh. The disorder exhibits a wide range of clinical and laboratory features in children. Judicial fluid resuscitation during the critical phase and prompt referral to the appropriate health facility can be lifesaving. Objectives This research appraised clinical and laboratory features and treatment outcomes of DF in pediatric cases. Methods This prospective investigative work was conducted at Islami Bank Hospital, Dhaka, India, from July to October 2023. The study included 135 admitted pediatric cases of DF, either dengue nonstructural protein 1 (NS1) or anti-dengue antibody IgM or IgG positive. Results Among the selected cases, boys were more predominant than girls, and most patients were in the age group of 5 to 10 years (n=46, 34%), most of them belonging to lower-middle-class families (n=56, 41.5%). All of the study participants had raised body temperatures, and most had abdominal pain (n=82, 60.7%), vomiting (n=77, 57%), cough (n=43, 31.9%), headache (n=38, 28.2%), body aches (n=32, 23.7%), and diarrhea (n=23, 17%). Dengue NS1 was positive in 91.1% (n=123) of cases. Raised hematocrit was found in 36.3% (n=49) of cases, leukopenia in 47% (n=63), and thrombocytopenia in 69.6% (n=94) of cases. Most of our patients were categorized as having DF (68.1%, n=92), followed by dengue with warning signs (16.3%, n=22), and severe dengue was present in 15.6% (n=21) of patients. Most were treated with crystalloid, and some with crystalloid and colloid solution. Fortunately, most of them recovered with no death. Conclusion DF may manifest with varied clinical and laboratory features in children. Appropriate treatment of critical phases, depending on clinical and laboratory features, is crucial to reducing dengue-induced miseries and fatal clinical outcomes among the pediatric population.

摘要

背景

在全球范围内,登革热(DF)是节肢动物传播的病毒性疾病的主要病因,其导致了相当高的死亡率。该疾病目前在世界上的一些地区呈地方性流行,包括孟加拉国。这种疾病在儿童中表现出广泛的临床和实验室特征。在关键阶段进行合理的液体复苏并及时转诊至合适的医疗机构可挽救生命。

目的

本研究评估了儿童登革热病例的临床和实验室特征及治疗结果。

方法

这项前瞻性调查研究于2023年7月至10月在印度达卡的伊斯兰银行医院进行。该研究纳入了135例登革热非结构蛋白1(NS1)或抗登革热抗体IgM或IgG呈阳性的住院儿童登革热病例。

结果

在所选病例中,男孩比女孩更常见,大多数患者年龄在5至10岁之间(n = 46,34%),其中大多数属于中低收入家庭(n = 56,41.5%)。所有研究参与者体温均升高,大多数有腹痛(n = 82,60.7%)、呕吐(n = 77,57%)、咳嗽(n = 43,31.9%)、头痛(n = 38,28.2%)、身体疼痛(n = 32,23.7%)和腹泻(n = 2,3,17%)。91.1%(n = 123)的病例登革热NS1呈阳性。36.3%(n = 49)的病例血细胞比容升高,47%(n = 63)的病例白细胞减少,69.6%(n = 94)的病例血小板减少。大多数患者被归类为患有登革热(68.1%,n = 92),其次是有警示体征的登革热(16.3%,n = 22),15.6%(n = 21)的患者患有重症登革热。大多数患者接受晶体液治疗,一些患者接受晶体液和胶体溶液治疗。幸运的是,大多数患者康复且无死亡病例。

结论

登革热在儿童中可能表现出各种临床和实验室特征。根据临床和实验室特征对关键阶段进行适当治疗对于减少儿童人群中登革热引起的痛苦和致命临床结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d76/11654319/4afc4f1505a3/cureus-0016-00000075840-i01.jpg

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