Skip to main content
Top
Published in: Pediatric Radiology 8/2013

01-08-2013 | Original Article

Ultrasonography as a tool in predicting the severity of dengue fever in children—a useful aid in a developing country

Authors: K. R. Bharath Kumar Reddy, Ramesh R. Laksmana, Basavaraja G. Veerappa, Shivananda

Published in: Pediatric Radiology | Issue 8/2013

Login to get access

Abstract

Background

Dengue fever accounts for significant mortality in developing countries. Dengue fever serology takes a week at least to be reported positive, thus necessitating the need for other markers of diagnosis and prognosis.

Objective

The purpose of this study was to investigate the role of ultrasonography as a tool in diagnosing and predicting the severity of dengue fever in children.

Materials and methods

This was a prospective study conducted in a tertiary pediatric centre from September 2010 to July 2012. Three hundred twenty-four children with confirmed dengue fever were compared with 422 children of suspected dengue fever. Severity of illness was graded as per WHO criteria and sonography findings were correlated to the grade of illness.

Results

Gallbladder wall thickening was seen in 75% of the children with confirmed dengue fever. A significant difference was seen between survivors and non-survivors with respect to pericholecystic fluid collection (P = 0.002), hepatic intraparenchymal fluid (P < 0.001), splenomegaly (P = 0.002), splenic subcapsular fluid (P < 0.001), peripancreatic fluid (P < 0.001), perirenal fluid (P < 0.001) and pericardial fluid (P < 0.001). Other findings included ascites, pleural effusion, hepatomegaly and splenomegaly, which were present irrespective of grade of illness.

Conclusions

Ultrasonography can be used as a useful tool in developing countries to predict the severity of dengue fever in children.
Literature
1.
go back to reference World Health Organization (1997) Dengue haemorrhagic fever: diagnosis, treatment, prevention, and control, 2nd edn. World Health Organization, Geneva World Health Organization (1997) Dengue haemorrhagic fever: diagnosis, treatment, prevention, and control, 2nd edn. World Health Organization, Geneva
2.
go back to reference Rahman M, Rahman K, Siddique AK et al (2002) First outbreak of dengue haemorrhagic fever, Bangladesh. Emerg Infect 8:738–740CrossRef Rahman M, Rahman K, Siddique AK et al (2002) First outbreak of dengue haemorrhagic fever, Bangladesh. Emerg Infect 8:738–740CrossRef
3.
go back to reference Sai PMV, Dev B, Krishnan R (2005) Role of ultrasound in dengue fever. Br J Radiol 78:416–418CrossRef Sai PMV, Dev B, Krishnan R (2005) Role of ultrasound in dengue fever. Br J Radiol 78:416–418CrossRef
4.
go back to reference Setiawan MW, Samsi TK, Wulur H et al (1998) Dengue haemorrhagic fever: ultrasound as an aid to predict the severity of the disease. Pediatr Radiol 28:1–4PubMedCrossRef Setiawan MW, Samsi TK, Wulur H et al (1998) Dengue haemorrhagic fever: ultrasound as an aid to predict the severity of the disease. Pediatr Radiol 28:1–4PubMedCrossRef
5.
go back to reference Wu KL, Changchien CS, Kuo CH et al (2004) Early abdominal sonographic findings in patients with dengue fever. Clin Ultrasound 32:386–388CrossRef Wu KL, Changchien CS, Kuo CH et al (2004) Early abdominal sonographic findings in patients with dengue fever. Clin Ultrasound 32:386–388CrossRef
6.
go back to reference Thulkar S, Sharma S, Srivastava DN et al (2000) Sonographic findings in grade III dengue hemorrhagic fever in adults. J Clin Ultrasound 28:34–37PubMedCrossRef Thulkar S, Sharma S, Srivastava DN et al (2000) Sonographic findings in grade III dengue hemorrhagic fever in adults. J Clin Ultrasound 28:34–37PubMedCrossRef
7.
go back to reference Pramuljo HS, Harun SR (1991) Ultrasound findings in dengue haemorrhage fever. Pediatr Radiol J 21:100–102CrossRef Pramuljo HS, Harun SR (1991) Ultrasound findings in dengue haemorrhage fever. Pediatr Radiol J 21:100–102CrossRef
8.
go back to reference Venkata S, Dev B, Krishnan R (2005) Role of ultrasound in dengue fever. Br J Radiol 78:416–418CrossRef Venkata S, Dev B, Krishnan R (2005) Role of ultrasound in dengue fever. Br J Radiol 78:416–418CrossRef
9.
go back to reference Setiawan MW, Samsi TK, Pool TN et al (1995) Gallbladder wall thickening in dengue hemorrhagic fever: an ultrasonographic study. J Clin Ultrasound 23:357–362PubMedCrossRef Setiawan MW, Samsi TK, Pool TN et al (1995) Gallbladder wall thickening in dengue hemorrhagic fever: an ultrasonographic study. J Clin Ultrasound 23:357–362PubMedCrossRef
10.
go back to reference Quiroz-Moreno R, Mendez GF, Ovando-Rivera KM (2006) Clinical utility of ultrasound in the identification of dengue hemorrhagic fever. Rev Med Inst Mex Seguro Soc 44:243–248PubMed Quiroz-Moreno R, Mendez GF, Ovando-Rivera KM (2006) Clinical utility of ultrasound in the identification of dengue hemorrhagic fever. Rev Med Inst Mex Seguro Soc 44:243–248PubMed
11.
go back to reference Srikiatkhachorn A, Krautrachue A, Ratanaprakarn W et al (2007) Natural history of plasma leakage in dengue hemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J 26:283–292PubMedCrossRef Srikiatkhachorn A, Krautrachue A, Ratanaprakarn W et al (2007) Natural history of plasma leakage in dengue hemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J 26:283–292PubMedCrossRef
12.
go back to reference Colbert JA, Gordon A, Roxelin R et al (2007) Ultrasound measurement of gallbladder wall thickening as a diagnostic test and prognostic indicator for severe dengue in pediatric patients. Pediatr Infect Dis J 26:850–852PubMedCrossRef Colbert JA, Gordon A, Roxelin R et al (2007) Ultrasound measurement of gallbladder wall thickening as a diagnostic test and prognostic indicator for severe dengue in pediatric patients. Pediatr Infect Dis J 26:850–852PubMedCrossRef
13.
go back to reference Lei HY, Yeh TM, Liu HS et al (2001) Immunopathogenesis of dengue virus infection. J Biomed Sci 8:377–388PubMedCrossRef Lei HY, Yeh TM, Liu HS et al (2001) Immunopathogenesis of dengue virus infection. J Biomed Sci 8:377–388PubMedCrossRef
14.
go back to reference Joshi P, Rathnam VG, Sharma S (1997) USG findings in dengue haemorrhagic fever—our experience in the recent epidemic. Ind J Radiol Imag 7:189–192 Joshi P, Rathnam VG, Sharma S (1997) USG findings in dengue haemorrhagic fever—our experience in the recent epidemic. Ind J Radiol Imag 7:189–192
15.
go back to reference Mia MW, Nurullah AM, Hossain A et al (2010) Clinical and sonographic evaluation of dengue fever in Bangladesh: a study of 100 cases. Dinajpur Med Col J 3:29–34 Mia MW, Nurullah AM, Hossain A et al (2010) Clinical and sonographic evaluation of dengue fever in Bangladesh: a study of 100 cases. Dinajpur Med Col J 3:29–34
16.
go back to reference Setiawan MW, Samsi TK, Pool TN et al (1995) Early diagnosis of dengue haemorrhagic fever. Ultrasound Int 1:140 Setiawan MW, Samsi TK, Pool TN et al (1995) Early diagnosis of dengue haemorrhagic fever. Ultrasound Int 1:140
17.
go back to reference Halstead SB (1982) Dengue: hematologic aspects. Semin Hematol 19:116PubMed Halstead SB (1982) Dengue: hematologic aspects. Semin Hematol 19:116PubMed
18.
go back to reference Guzman MG, Kouri G, Valdes L et al (2000) Epidemiologic studies on dengue in Santiago de Cuba, 1997. Am J Epidemiol 152:793–799PubMedCrossRef Guzman MG, Kouri G, Valdes L et al (2000) Epidemiologic studies on dengue in Santiago de Cuba, 1997. Am J Epidemiol 152:793–799PubMedCrossRef
19.
go back to reference Halstead SB, Heinz FX (2005) Dengue virus: molecular basis of cell entry and pathogenesis. Vaccine 23:849–856PubMedCrossRef Halstead SB, Heinz FX (2005) Dengue virus: molecular basis of cell entry and pathogenesis. Vaccine 23:849–856PubMedCrossRef
20.
go back to reference Bhamarapravati N, Tuchinda P, Boonyapaknavik V (1967) Pathology of Thailand haemorrhagic fever: a study of 100 autopsy cases. Ann Trop Med Parasitol 61:500–510PubMed Bhamarapravati N, Tuchinda P, Boonyapaknavik V (1967) Pathology of Thailand haemorrhagic fever: a study of 100 autopsy cases. Ann Trop Med Parasitol 61:500–510PubMed
Metadata
Title
Ultrasonography as a tool in predicting the severity of dengue fever in children—a useful aid in a developing country
Authors
K. R. Bharath Kumar Reddy
Ramesh R. Laksmana
Basavaraja G. Veerappa
Shivananda
Publication date
01-08-2013
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 8/2013
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-013-2642-0

Other articles of this Issue 8/2013

Pediatric Radiology 8/2013 Go to the issue