A Study of Clinical Profile of Dengue Fever in Kollam, Kerala, India ¶

Abstract

A large urban epidemic of dengue fever occurred in Kollam city of Kerala in 2003. During this epidemic, a study was conducted among 250 IgM dengue antibody-confirmed cases admitted to three major hospitals in Kollam city. The presenting symptoms were: fever (96.8%), headache (77.2%), abdominal pain (62.4%), diarrhoea (15.2%), bleeding (15.2%), skin rash (13.2%), pruritus (10.4%), sore throat (5.2%), and seizures (0.8%). The major physical findings noted included positive tourniquet test (33.67%), hepatomegaly (17.6%), bradycardia (16.8%), pleural effusion (13.2%) and ascites (12%). The most frequent abnormal laboratory findings included haemoconcentration (27.8%) and severe thrombocytopenia (<10 000 in 8.5%). Eight out of 250 patients died (case-fatality rate (CFR) = 3.2%). In all the 8 cases of death, disseminated intravascular coagulation (DIC) was the cause of death. DIC was associated with thrombocytopenia (platelet count-50 000/cmm) and haemoconcentration (7 out of 8 cases).