Dengue deaths: A clinical experience in critical unit

Aim: to evaluate the clinical features,complications and outcome of patients with dengue fever. study design: this was an observational study. period: in epidemic of dengue fever from september 2011 to 31 october 2011 setting: this study was carried out at medical icu ittefaq hospital modal town lahore. inclusion criteria: all patients with acute febrile illness with low tlc count,low platelets count and anti-dengue igm and igg positive which were admitted to icu with complications exclusion criteria: 1: all patient with acute febrile illness with low blood count but negative antibodies serology. 2: all patients with co morbidities like diabetes,chronic liver disease,chronic renal failure methods: all patients above 12 years of age with acute febrile illness due to dengue fever were observed for complications and statistical analysis was done on spss 11 programme. results: out of 128 patients 122(95.31%) patient were in shock and 6(4.68%) were unconscious dengue leakage shock 6(4.9%) and 2(1.6%) cases were in dengue hemorrhagic shock cardiac shock was noted in 24(19.67%) cases and 94(77%) cases were in hypovolemic shock. out of 24(19.67%) cases of myocarditis 20patients expired despite all cardiac support and 4 cases recovered over period of two weeks. all patients of simple hypovolemic shock due to vomiting or poor oral intake were excellent managed with crystalline fluid. six (4.68%) cases were having dengue encephalitis confirmed on csf examination and mri brain. one unusual observation was that patients were having bilateral thalamic and bilateral basal ganglia infarction which is unusual site for viral encephalitis conclusion: dengue myocarditis,dengu encephalitis and dengue multiorgan failure are major killer in dengue fever not dengue shock syndrome or dengue hemorrhagic shock and coagulopathy in dengue fever is independent of platelets count.