Background: Dengue is the most rapidly spreading mosquito-borne viral disease. The spectrum ranges from a nonspecific febrile illness to severe disease, i.e., dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) with the development of hematological complications. Since the death in these patients is due to hematological complications, their study would have a substantial impact on reducing the mortality and morbidity associated with dengue.
Objective: The objective of this study was to evaluate the hematological changes in serologically positive dengue patients and to correlate the same with different stages of serology and clinical outcome.
Materials and Methods: Evaluation of the hematological parameters and peripheral smear study in clinically suspected cases of dengue with serological confirmation was carried out. Clinical data along with the outcome were collected from medical records. Chi-square test, somatosensory evoked potential, and logistic regression analysis were applied to analyze the results.
Results: Three hundred and forty-eight serologically positive dengue cases were analyzed. The disease manifested as dengue fever (DF) in 83.5% of cases, DHF in 10.6% of cases, and DSS in 4.9% of cases. Thrombocytopenia was the most common hematological finding followed by anemia, leukopenia, leukocytosis, and increased hematocrit. Peripheral smears showed atypical lymphocytes, neutrophilic toxic granules, giant platelets, and granulocytic shift to left. About 94.26% of patients recovered and 3.45% had fatal outcome.
Conclusion: Platelet count and hematocrit play a crucial role in predicting prognosis of DHF and DSS. Thrombocytopenia was associated more with DHF and DSS than DF. There was a significant association between decreased platelet count and mortality rate.
Key words: Dengue Virus; Dengue Fever; Dengue Hemorrhagic Fever; Dengue Shock Syndrome; Thrombocytopenia
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