STUDY ON OUTCOME OF CHILDREN WITH DENGUE INFECTION AND ITS CLINICAL CORRELATION WITH HEPATIC DYSFUNCTION

Dr. Deepthi B.*, Dr. Sanjeev Chetty and Dr. Malleshappa

ABSTRACT

Introduction: Dengue virus infection is a major public health problem and hepatic involvement in dengue is known with protean of manifestations ranging from hepatomegaly, elevated liver enzymes to fulminant hepatic failure. This objective of the study was to assess the spectrum of hepatic involvement in dengue infection. Methodology: A prospective cohort study on 110 Patients hospitalized with dengue infection admitted in Dept. of pediatrics, Navodaya Medical College, Raichur. Children aged between 2 months - 14 years were studied for their hepatic functions both clinically and biochemically. Results: Fever (100%) was the chief complaint in all cases followed by body aches (57%), pain in abdomen (47%), vomiting (40%) facial puffiness (40%) and rashes (36%). Petichiae and purpura were seen in 30% of cases, while 19 % had mucosal bleeding. Five (4.5%) children presented with jaundice. Out of 110 children, 79 % had hepatomegaly which was noticed more in DHF and DSS (88.5% and 96%) than in DF (67.8%) group (P=0.006). Hepatic tenderness was more in DHF (53.8%), DSS (56%) compared to DF(20.3%) group (P=0.001). Abnormal liver functions were significantly more in DSS and DHF group. Conclusion: Hepatic involvement in dengue varies from jaundice to more than 10-folds elevation of liver enzymes. Significant rise of liver enzymes signifies severe dengue. There was no correlation between the degree of hepatic enlargement or hepatic tenderness with the abnormalities of liver functions. Any child with fever, jaundice and tender hepatomegaly in geographical areas where dengue is endemic, the diagnosis of dengue infection should be strongly considered.

Keywords: Dengue; Hepatmegaly; Jaundice; Elevated liver enzymes.