A clinical and biochemical laboratory profile to measure the severity of dengue fever and their outcome

Maddipatla Sushma, M. V. Nagabhushana, M. Dharaneedhar Reddy


Background: To identify various manifestations of dengue fever, complications, and to measure their association with laboratory findings.

Methods: 100 cases of suspected adults between 20-70 years of age with clinical features suggestive of dengue infection and patients presenting with fever of acute onset (<2 weeks), pain abdomen, vomiting, rash, flushed appearance and bleeding manifestation were studied. All cases were followed up for the clinical and laboratory parameters and treated according to WHO guidelines.

Results: 36 were classified as classical dengue fever, 33 as dengue haemorrhagic fever (DHF), 15 as dengue shock syndrome (DSS), and 16 as dengue-like illness (DLI) and the common age group was 30-40 year (50%). Most (66%) of the patients were male. The common presenting symptoms was fever 65%, vomiting (40%), abdominal pain (40%), myalgia (7%), etc. Hepatomegaly (53%), ascites (1%), splenomegaly (8%) was noted. The mean platelet in the present study was 41870 cells/cu mm. Elevated liver enzymes and elevated serum creatinine was found in complicated forms of disease. The prothrombin time ranged from 11-60 sec with a mean of 19.5 sec.

Conclusions: The treatment of dengue is mainly supportive, but early institution and meticulous monitoring are the important steps for positive outcome. Much more awareness, vigilance and research in the diagnostic modalities are further needed to avoid unnecessary panic and platelet transfusions.


Thrombocytopenia, Dengue fever, Liver enzymes, Haematocrit

Full Text:



World Health organization, Dengue: guideline for diagnosis, treatment, prevention and control, new edition. 2009;1.

Bhatt S, Gething P, Brady WOJ, et al. The global distribution and burden of dengue. Nature. 2013;496:504-7.

Brady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG et al. Refining the Global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis. 2012;6:e1760.

Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S et al. Early clinical and laboratory indicators of acute Dengue illness. J Infect Dis. 1997;176:313-21.

Malavige GN, Fernando S, Fernando DJ, Seneviratne SL. Dengue viral infections. Postgrad Med J. 2004;80:588-601.

WPRO Dengue WHO Western Pacific Region. Available from: and Accessed on 11 October 2020.

Teoh EP, Kukkaro P, Teo EW, Lim AP, Tan TT, Yip A et al. The structural basis for serotype-specific neutralization of dengue virus by a humanantibody. Sci Transl Med. 2012;4(139):139-83.

Gubler DJ. Dengue and dengue hemorrhagic fever. Clinical microbiology reviews. 1998;11(3):480-96.

Gupta N, Srivastava S, Jain A, Chaturvedi UC. Dengue in India. Indian J Med Res. 2012;136(3):373-90.

NEA Murray, Quam MB, Wilder smith A, Epidemiology of dengue: past, present and future prospects. Clin epidemiol. 2013;5:299-309.

Sarkar JK, Chatterjee SN, Chakravarty SK. Haemorrhagic fever in Calcutta: some epidemiological observations. Indian J Med Res. 1964;52:651-9.

Chatterjee SN, Chakravarti SK, Mitra AC, Sarkar JK. Virological investigation of cases with neurological complications during the outbreak of haemorrhagic fever in Calcutta. J Indian Med Assoc. 1965;45:314-6.

Paul SD, Dandawate CN, Banerjee K, Krishnamurthy K. Virological and serological studies on an outbreak of dengue like illness in Visakhapatnam, Andhra Pradesh. Indian J Med Res. 1965;53:777-89.

Myers RM, Varkey MJ, Reuben R, Jesudass ES. Dengue outbreak in Vellore, southern India, in 1968, with isolation of four dengue types from man and mosquitoes. Indian J Med Res. 1970; 58 : 24-30.

Myers RM, Varkey MJ. A note on sequential dengue infection, presumptive and proved, with report of an instance of a third proved attack in one individual. Indian J Med Res 1971;59:1231-6.

Mahadev PV, Kollali VV, Rawal ML, Pujara PK, Shaikh BH, Ilkal MA et al. Dengue in Gujarat state, India during 1988 and 1989. Indian J Med Res. 1993;97:135-44.

Kumar A, Sharma SK, Padbidri VS, Thakare JP, Jain DC, Datta KK. An outbreak of dengue fever in rural areas of northern India. J Commun Dis. 2001;33:274-81.

Kurukumbi M, Wali JP, Broor S, Aggarwal P, Seth P, Handa R et al. Seroepidemiology and active surveillance of dengue fever/dengue haemorrhagic fever in Delhi. Indian J Med Sci. 2001;55:149-56.

Dash PK, Saxena P, Abhyankar A, Bhargava R, Jana AM. Emergence of dengue virus type-3 in northern India. Southeast Asian J Trop Med Public Health. 2005;36:370-7.