Vol. 5, Issue 12 (2019)
Clinical profile and outcome of dengue in children admitted in pediatric intensive care unit in Dhaka shishu (Children) Hospital, Dhaka, Bangladesh
Author(s): Md Shafiul Hoque, Probir Kumar Sarkar, ASM Nawshad Uddin Ahmed
Abstract: Background: As dengue being a tropical infection presenting with varying degrees of severity of illness in Bangladeshi children, it is important to study the clinical profile, outcome, and predictors for mortality of moderate and severe dengue cases. Objective: To find out the clinical profile and outcome of dengue in children admitted in PICU. Study Design: Retrospective study. Place and Duration of Study: Pediatric intensive care unit of Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh from April 2018 to March 2019. Methods: All patients admitted in PICU with the diagnosis of dengue fever during the study period were included in this study. Clinical characteristics, laboratory parameters, complications, outcome and predictors for mortality were studied. Results: Fifty-eight seropositive dengue cases were admitted. Most common presenting symptoms were fever 58 (100%), vomiting 33 (56.8%) and abdominal pain 19 (32.7%). Among severe dengue (33), expanded dengue syndrome was present in 10 (30%) cases, expanded dengue syndrome with shock in 10 (30%), significant hemorrhage with shock in 2 (6%), hemorrhage without shock in 1(3%) and combination of expanded dengue syndrome with hemorrhage and shock in 10 (30%) cases. Pleural effusion was present in 38 (65.5%) and ascites in 18(31%) children. Among severe dengue, 12(36.3%) received invasive mechanical ventilation, 8(24%) received inotropes, 19(57.5%) received steroids and 7 (21%) had abdominal compartment syndrome requiring drainage of ascites. Conclusion: Significantly more number of children who died received ventilator support and inotropes. Commonest cause of death is catecholamine resistant shock. There is no major adverse effect of steroids when used in severe dengue.