Gascón J, Giner V, Vidal J, Jou J M, Mas E, Corachán M
Secció de Medicina Tropical, Hospital Clínic i Provincial, Universitat de Barcelona, IDIBAPS.
Med Clin (Barc). 1998 Nov 7;111(15):583-6.
Dengue infection is nowadays considered a re-emergent disease. It has a worldwide tropical and subtropical distribution. The dengue virus in a member of the flavivirus family composed by 4 different serotypes. The virus is transmitted by mosquitos of the Aedes genus. With the increment of travels to the endemic areas, dengue is now observed frequently in our country. We analyzed 57 patients, 30 with imported dengue (ID) and 27 with dengue fever suffered during the trip (DDT). This series is compared with other published ones and a review of the subject is presented. Patients with ID followed a protocol as a febril syndrome returning from the tropics. Dengue was diagnosed through a compatible clinico-epidemiological history, the absence of other ferbil illness and positivity of specific serology. All patients had travelled to endemic areas (Central America 28 cases, Indian subcontinent 15, South-East Asia 10, South America 2, West Africa one, and Pacific one). The following were the most important clinical characteristics: fever and asthenia (100%), headache (98%), mialgia (84%), arthralgia (72%), morbilliform rash (61%) and retroocular pain (65%). For ID cases, the most helpful analitical results were: leucopenia (70%), reactive lymphocytes in peripheral blood smear (70%), thrombocytopenia (70%), and increased hepatic enzymes ALAT (53%), ASAT (63%) and LDH (100% in the 7 patients tested for this enzyme). Dengue must be included in differential diagnosis of fever in patients coming back to travels to tropical areas.
如今,登革热感染被视为一种再度出现的疾病。它在全球热带和亚热带地区分布。登革病毒是黄病毒科的成员,由4种不同血清型组成。该病毒通过伊蚊属蚊子传播。随着前往流行地区旅行人数的增加,我国现在经常观察到登革热病例。我们分析了57例患者,其中30例为输入性登革热(ID),27例为旅行期间患登革热(DDT)。将该系列病例与其他已发表的病例进行比较,并对该主题进行综述。ID患者遵循作为从热带地区返回的发热综合征的方案。通过符合临床流行病学病史、无其他发热性疾病以及特异性血清学阳性来诊断登革热。所有患者均前往过流行地区(中美洲28例,印度次大陆15例,东南亚10例,南美洲2例,西非1例,太平洋地区1例)。以下是最重要的临床特征:发热和乏力(100%)、头痛(98%)、肌痛(84%)、关节痛(72%)、麻疹样皮疹(61%)和眼球后疼痛(65%)。对于ID病例,最有帮助的分析结果是:白细胞减少(70%)、外周血涂片反应性淋巴细胞(70%)、血小板减少(70%)以及肝酶ALAT升高(53%)、ASAT升高(63%)和LDH升高(在检测该酶的7例患者中为100%)。对于从热带地区旅行归来发热患者的鉴别诊断中必须考虑登革热。