USEFUL CLINICAL FEATURES AND HEMATOLOGICAL PARAMETER FOR THE DIAGNOSIS OF DENGUE INFECTION IN ACUTE FEBRILE ILLNESS PATIENTS
(Abstract release date: 05/19/16)
EHA Library. Tantiworawit A. 06/09/16; 134802; PB1902
Dr. Adisak Tantiworawit
Contributions
Contributions
Abstract
Abstract: PB1902
Type: Publication Only
Background
Dengue infected patients are presented with acute febrile illness without localizing signs and symptoms. Clinical presentations may mimic other infections. The serology (Dengue nonstructural protein 1 (NS1) antigen or Dengue IgM antibody) for definite diagnosis is costly and inaccessible in many hospitals. There was no study to identify these daily changes to distinguish dengue infection from the other causes in acute febrile illness patients.
Aims
The aim of the study was to identify the clinical features and hematologic parameters from complete blood count (CBC) to distinguish dengue infection from the other causes in acute febrile illness patients.
Methods
This was a retrospective study. All patients who presented with acute fever between September 2013 and July 2015 were included. The diagnosis with dengue infection must be confirmed by serology (Dengue NS1 antigen or IgM antibody). The control group included rickettsia, leptospirosis, malaria, and primary bacteremia patients who also presented with acute febrile illness without localizing signs. The sample size by calculation was 300 and divided in to 2 groups. Clinical data and CBC results from diagnosis until recovery were reviewed and compared between two groups.
Results
One hundred fifty-four dengue patients and 146 control patients were included. Headache, nausea, loss of appetite and bleeding diathesis were significantly presented in dengue patients compared to control group 47.4 vs 34.2, 33.8 vs 15.1, 34.4 vs 15.8, 5.8 vs 0 % respectively (p=0.05). There were several hematologic parameters from CBC which were diverse in dengue patients compared to control group. Moreover, this study also identified the day of fever which these parameters were statistically significant. The dengue group had higher hemoglobin and hematocrit from day 3 to day 10 (highest on day 7; 14.3 vs 12.9 g/dl, 43.3 vs 39.2%, p <0.001), lower white blood cell (WBC) count from day 1 to day 10 (lowest on day 4; 3,333 vs 8,561 per cu.mm., p <0.001) and lower platelet count from day 3 to day 10 (lowest on day 6; 68,910 vs 196,137 per cu.mm., p <0.001). For the differential count of WBC, dengue infection showed higher monocytes on day 1-4 (highest on day 2; 11.7 vs 5.4%, p <0.001), higher atypical lymphocytes on day 5-9 (highest on day 7; 13 vs 0.4%, p <0.001) and higher eosinophils on day 9-10 (highest on day 9; 2.2 vs 0.7%, p 0.001). Furthermore, the neutrophil to lymphocyte ratio of dengue group was >1 on the first 5 days then reversed on day 6 to Day 9 (0.69, 0.89, 0.83, and 0.80 respectively) but in non-dengue group, the ratio was always > 1.
Conclusion
We identified important clinical features and useful CBC parameters to differentiate dengue patients from other causes of acute febrile illness patients. This could be done in local hospital to give diagnosis, tailor to further investigation and early treatment.
Session topic: E-poster
Keyword(s): Infection
Type: Publication Only
Background
Dengue infected patients are presented with acute febrile illness without localizing signs and symptoms. Clinical presentations may mimic other infections. The serology (Dengue nonstructural protein 1 (NS1) antigen or Dengue IgM antibody) for definite diagnosis is costly and inaccessible in many hospitals. There was no study to identify these daily changes to distinguish dengue infection from the other causes in acute febrile illness patients.
Aims
The aim of the study was to identify the clinical features and hematologic parameters from complete blood count (CBC) to distinguish dengue infection from the other causes in acute febrile illness patients.
Methods
This was a retrospective study. All patients who presented with acute fever between September 2013 and July 2015 were included. The diagnosis with dengue infection must be confirmed by serology (Dengue NS1 antigen or IgM antibody). The control group included rickettsia, leptospirosis, malaria, and primary bacteremia patients who also presented with acute febrile illness without localizing signs. The sample size by calculation was 300 and divided in to 2 groups. Clinical data and CBC results from diagnosis until recovery were reviewed and compared between two groups.
Results
One hundred fifty-four dengue patients and 146 control patients were included. Headache, nausea, loss of appetite and bleeding diathesis were significantly presented in dengue patients compared to control group 47.4 vs 34.2, 33.8 vs 15.1, 34.4 vs 15.8, 5.8 vs 0 % respectively (p=0.05). There were several hematologic parameters from CBC which were diverse in dengue patients compared to control group. Moreover, this study also identified the day of fever which these parameters were statistically significant. The dengue group had higher hemoglobin and hematocrit from day 3 to day 10 (highest on day 7; 14.3 vs 12.9 g/dl, 43.3 vs 39.2%, p <0.001), lower white blood cell (WBC) count from day 1 to day 10 (lowest on day 4; 3,333 vs 8,561 per cu.mm., p <0.001) and lower platelet count from day 3 to day 10 (lowest on day 6; 68,910 vs 196,137 per cu.mm., p <0.001). For the differential count of WBC, dengue infection showed higher monocytes on day 1-4 (highest on day 2; 11.7 vs 5.4%, p <0.001), higher atypical lymphocytes on day 5-9 (highest on day 7; 13 vs 0.4%, p <0.001) and higher eosinophils on day 9-10 (highest on day 9; 2.2 vs 0.7%, p 0.001). Furthermore, the neutrophil to lymphocyte ratio of dengue group was >1 on the first 5 days then reversed on day 6 to Day 9 (0.69, 0.89, 0.83, and 0.80 respectively) but in non-dengue group, the ratio was always > 1.
Conclusion
We identified important clinical features and useful CBC parameters to differentiate dengue patients from other causes of acute febrile illness patients. This could be done in local hospital to give diagnosis, tailor to further investigation and early treatment.
Session topic: E-poster
Keyword(s): Infection
Abstract: PB1902
Type: Publication Only
Background
Dengue infected patients are presented with acute febrile illness without localizing signs and symptoms. Clinical presentations may mimic other infections. The serology (Dengue nonstructural protein 1 (NS1) antigen or Dengue IgM antibody) for definite diagnosis is costly and inaccessible in many hospitals. There was no study to identify these daily changes to distinguish dengue infection from the other causes in acute febrile illness patients.
Aims
The aim of the study was to identify the clinical features and hematologic parameters from complete blood count (CBC) to distinguish dengue infection from the other causes in acute febrile illness patients.
Methods
This was a retrospective study. All patients who presented with acute fever between September 2013 and July 2015 were included. The diagnosis with dengue infection must be confirmed by serology (Dengue NS1 antigen or IgM antibody). The control group included rickettsia, leptospirosis, malaria, and primary bacteremia patients who also presented with acute febrile illness without localizing signs. The sample size by calculation was 300 and divided in to 2 groups. Clinical data and CBC results from diagnosis until recovery were reviewed and compared between two groups.
Results
One hundred fifty-four dengue patients and 146 control patients were included. Headache, nausea, loss of appetite and bleeding diathesis were significantly presented in dengue patients compared to control group 47.4 vs 34.2, 33.8 vs 15.1, 34.4 vs 15.8, 5.8 vs 0 % respectively (p=0.05). There were several hematologic parameters from CBC which were diverse in dengue patients compared to control group. Moreover, this study also identified the day of fever which these parameters were statistically significant. The dengue group had higher hemoglobin and hematocrit from day 3 to day 10 (highest on day 7; 14.3 vs 12.9 g/dl, 43.3 vs 39.2%, p <0.001), lower white blood cell (WBC) count from day 1 to day 10 (lowest on day 4; 3,333 vs 8,561 per cu.mm., p <0.001) and lower platelet count from day 3 to day 10 (lowest on day 6; 68,910 vs 196,137 per cu.mm., p <0.001). For the differential count of WBC, dengue infection showed higher monocytes on day 1-4 (highest on day 2; 11.7 vs 5.4%, p <0.001), higher atypical lymphocytes on day 5-9 (highest on day 7; 13 vs 0.4%, p <0.001) and higher eosinophils on day 9-10 (highest on day 9; 2.2 vs 0.7%, p 0.001). Furthermore, the neutrophil to lymphocyte ratio of dengue group was >1 on the first 5 days then reversed on day 6 to Day 9 (0.69, 0.89, 0.83, and 0.80 respectively) but in non-dengue group, the ratio was always > 1.
Conclusion
We identified important clinical features and useful CBC parameters to differentiate dengue patients from other causes of acute febrile illness patients. This could be done in local hospital to give diagnosis, tailor to further investigation and early treatment.
Session topic: E-poster
Keyword(s): Infection
Type: Publication Only
Background
Dengue infected patients are presented with acute febrile illness without localizing signs and symptoms. Clinical presentations may mimic other infections. The serology (Dengue nonstructural protein 1 (NS1) antigen or Dengue IgM antibody) for definite diagnosis is costly and inaccessible in many hospitals. There was no study to identify these daily changes to distinguish dengue infection from the other causes in acute febrile illness patients.
Aims
The aim of the study was to identify the clinical features and hematologic parameters from complete blood count (CBC) to distinguish dengue infection from the other causes in acute febrile illness patients.
Methods
This was a retrospective study. All patients who presented with acute fever between September 2013 and July 2015 were included. The diagnosis with dengue infection must be confirmed by serology (Dengue NS1 antigen or IgM antibody). The control group included rickettsia, leptospirosis, malaria, and primary bacteremia patients who also presented with acute febrile illness without localizing signs. The sample size by calculation was 300 and divided in to 2 groups. Clinical data and CBC results from diagnosis until recovery were reviewed and compared between two groups.
Results
One hundred fifty-four dengue patients and 146 control patients were included. Headache, nausea, loss of appetite and bleeding diathesis were significantly presented in dengue patients compared to control group 47.4 vs 34.2, 33.8 vs 15.1, 34.4 vs 15.8, 5.8 vs 0 % respectively (p=0.05). There were several hematologic parameters from CBC which were diverse in dengue patients compared to control group. Moreover, this study also identified the day of fever which these parameters were statistically significant. The dengue group had higher hemoglobin and hematocrit from day 3 to day 10 (highest on day 7; 14.3 vs 12.9 g/dl, 43.3 vs 39.2%, p <0.001), lower white blood cell (WBC) count from day 1 to day 10 (lowest on day 4; 3,333 vs 8,561 per cu.mm., p <0.001) and lower platelet count from day 3 to day 10 (lowest on day 6; 68,910 vs 196,137 per cu.mm., p <0.001). For the differential count of WBC, dengue infection showed higher monocytes on day 1-4 (highest on day 2; 11.7 vs 5.4%, p <0.001), higher atypical lymphocytes on day 5-9 (highest on day 7; 13 vs 0.4%, p <0.001) and higher eosinophils on day 9-10 (highest on day 9; 2.2 vs 0.7%, p 0.001). Furthermore, the neutrophil to lymphocyte ratio of dengue group was >1 on the first 5 days then reversed on day 6 to Day 9 (0.69, 0.89, 0.83, and 0.80 respectively) but in non-dengue group, the ratio was always > 1.
Conclusion
We identified important clinical features and useful CBC parameters to differentiate dengue patients from other causes of acute febrile illness patients. This could be done in local hospital to give diagnosis, tailor to further investigation and early treatment.
Session topic: E-poster
Keyword(s): Infection
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