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Sonographic Evidence of Ascites, Pleura-Pericardial Effusion and Gallbladder Wall Edema for Dengue Fever

Published online by Cambridge University Press:  26 November 2011

M. Motla ,
S. Manaktala ,
V. Gupta ,
M. Aggarwal ,
S.K. Bhoi ,
P. Aggarwal  and
A. Goel
M. Motla
Affiliation:
Yahoda Hospital, Ghaziabad, India
S. Manaktala
Affiliation:
All India Institute of Medical Sciences, New Delhi, India
V. Gupta
Affiliation:
University of Pittsburgh Medical Center (UPMC) Mercy, Pittsburgh, Pensylvania USA
M. Aggarwal
Affiliation:
Yahoda Hospital, Ghaziabad, India
S.K. Bhoi
Affiliation:
All India Institute of Medical Sciences, New Delhi, India
P. Aggarwal
Affiliation:
All India Institute of Medical Sciences, New Delhi, India
A. Goel*
Affiliation:
University College of Medical Sciences, Delhi, India
*
Correspondence: Ashish Goel Lecturer, Department of MedicineUniversity College of Medical SciencesDelhi 11095, India E-mail: [email protected]
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Abstract

Introduction: Radiographic findings of dengue fever have not yet been clearly elucidated in relation to clinical and serological findings, despite the fact that two-fifths of the world population lives in areas where the virus is endemic. The current study is a retrospective analyzis of ultrasonographic (USG) features of patients presenting with probable dengue fever during the outbreak of DF of 2006 in North India.

Methods: Case records of a 169 patients with probable dengue fiver were included. Ten individual sonographic parameters were reviewed vis-à-vis ascites, hepatomegaly, splenomegaly, gall bladder wall edema (GBWE), pleural effusion (right or left or both), pericardial effusion, pericholecystic collection, perinephric collection. Subjects who had GB wall thickness >3 mm as measured on ultrasound were identified as positive for GBWE. The cases were analyzed in view of their serological profile.

Results: The mean age of the subjects was 27.9 +/− 13.4 years. The mean value of the platelet count was 57.4 +/− 22.3 x 103/cmm. The most common ultrasonographic feature was ascites (126, 74.6%) followed by gall bladder wall edema (122, 72%), hepatomegaly (78, 46.2%), splenomegaly (66, 39.1%) and pericholecystic collection (63, 37.3%); 48 (28.4%) subjects demonstrated evidence of pleural effusion on the right side, while 19 (11.2%) had bilateral effusion. None of the subjects had an isolated left pleural effusion. Twenty-seven (16%) subjects reported bleeding manifestations in the form of petechiae and five (3%) developed renal dysfunction. Presence of pleural and pericardial effusions was found to be specific while ascites and GBWE were identified as highly sensitive markers for seropositive Primary DF.

Conclusions: Ultrasonographic evidence of ascites, pleuro-pericardial effusion, and gallbladder wall edema are rapidly aquired, non-invasive markers of dengue and can be helpful before serological investigations become available. These findings may indicate severity and may herald the onset of bleeding (petechiae) or predict the development of acute renal dysfunction.

Keywords

dengue feverdengue outbreakdengue epidemicsonographultrasound
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 26 , Issue 5 , October 2011 , pp. 335 - 341
Copyright
Copyright Motla © World Association for Disaster and Emergency Medicine 2012

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