Clinical Profile and Outcome in Children of Dengue Hemorrhagic Fever in North India

Objective: the number of dengue fever (df)/dengue hemorrhagic fever (dhf) cases reported in india has risen in recent years. this study was undertaken to evaluate clinical profile and outcome of children admitted with dhf/dengue shock syndrome (dss), in the 2006 dhf epidemic in ludhiana, punjab.methods: eighty one children with dengue hemorrhagic fever were hospitalized in the pediatric department of dayanand medical college and hospital, ludhiana, india. all patients were diagnosed, managed and monitored according to a standard protocol.findings: children between 10-15 years were most commonly afflicted (59%). infants were the least affected sub-group (3.7%). ninety two percent of all children were of dhf and 8% cases presented in dss. the common symptoms seen were fever (91%), vomiting (41%), poor intake (21%), abdominal pain (16%) and significant bleeding (15%). hepatomegaly was present in 60% of cases. 85% of cases had petechiae alone, 15% had evidence of significant bleeding manifestation. gastrointestinal bleeding was the commonest observed bleeding. the complications seen were liver dysfunction (14.8%), coagulopathy (3.7%), renal dysfunction (3.7%), and acute respiratory distress syndrome (2.4%) and disseminated intravascular coagulation (1.2%). mortality in the study was 3.7%. refractory shock and coagulopathy were seen in all cases with poor outcome.conclusion: increased awareness, better transport facilities and case management according to the who guidelines, is needed to further reduce mortality of dhf/dss cases.