Role of ultrasound in diagnosis and early prediction of severity of dengue infection in children

Abstract

Abstract

Background and Objectives: Dengue has become a major health problem worldwide. The main objective of the study was to evaluate ultrasound features in children with dengue and determine its role in early diagnosis and predicting the severity of the disease.

Methods: 113 serology-positive cases from 1month-14years were divided into three clinical groups – dengue fever, dengue fever with warning signs and severe dengue. Ultrasound was performed during the critical phase and features were analyzed. Comparison was done between these groups by applying appropriate statistical analysis.

Results and interpretation: 75(66.3%) were diagnosed as Dengue fever, 16(14.1%) as Dengue with warning signs and 22(19.4%) as Severe dengue. Ultrasound features were, ascites(54,47.7%), gall bladder wall thickening(41,36.28%), pleural effusion(32,28.31%), splenomegaly(28,24.77%) and hepatomegaly(22,19.46%). The ultrasound features like ascites(p<0.05), pleural effusion(p<0.00001) and gall bladder wall thickening(p<0.00001) were significantly higher in Severe Dengue as compared to Dengue fever which suggest that these features predict severity of dengue. Hepatomegaly and splenomegaly showed no significant difference suggesting that it only supports the diagnosis.

Conclusion: Ultrasound can be used as an important supportive modality in early diagnosis of suspected dengue. In an epidemic, gall bladder wall thickening, ascites and pleural effusion favors the diagnosis of dengue fever and predicts its severity by identifying plasma leakage.