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Rash, degree of thrombocytopenia predicted dengue severity, mortality
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SAN DIEGO — The common warning signs of dengue — rash, vomiting, low mean arterial pressure, low platelets, signs of plasma leakage and anemia — were significantly associated with severe dengue and/or death in patients who were admitted to a large urban hospital in the Dominican Republic, Alfredo Mena Lora, MD, said during a presentation here.
“Our study validated the importance of the warning signs included in current dengue guidelines and suggested clinical findings that needed further investigation for future updates,” said Lora, of the University of Illinois at Chicago.
According to background information in the study abstract, the Dominican Republic is one of the countries with the highest prevalence of dengue reported in the Caribbean. For this reason, Lora and colleagues set out to evaluate the epidemiological characteristics, clinical profile and predictors of disease severity and mortality in 796 patients aged 1 to 16 years who were admitted with dengue to a large urban hospital in the Dominican Republic from 2008 to 2009. Fifty-nine percent of patients resided in urban areas; mean hemoglobin level was 10.5 g/dL; median platelet count was 54,000/mcL.
Overall, there were 288 cases of dengue; 290 categorized as dengue with alarm signs; and 207 were categorized as severe dengue. The most common symptoms of dengue were thrombocytopenia, abdominal pain, palpebral edema, vomiting and rash.
Of the 41 deaths that occurred during the study period, rash, gallbladder edema, low mean arterial pressure, pleural effusion and ascites were predictors of severe dengue.
“Rash and the degree of thrombocytopenia were predictors of disease severity and mortality, and this warrants further study,” Lora said. “We want to develop a prospective study that looks at this more closely and to include many other sites in the Dominican Republic as well.”
For more information:
Lora AM. #655. Presented at: ID Week; Oct. 17-21, 2012; San Diego.
Disclosure: Lora reports no relevant financial disclosures.