Clinical Features of Dengue Infection in Hospital for Tropical Diseases, Thailand

Background: Dengue infection is the common infectious disease in tropical countries caused by dengue virus, which has four serotypes (DEN 1, 2, 3 and 4). More data showed that dengue has caught worldwide attention due to its severe and fatal clinical outcome. This study aimed to describe the difference of clinical features of dengue infection between children and adults and among each dengue serotypes in Hospital for Tropical Diseases, Mahidol University, Bangkok, Thailand during 2011- 2013.

Study Design: This study was a hospital-based retrospective. In- patient medical record of 50 children and 148 adults with clinical and laboratory confirmed dengue infection and admitted to Hospital for Tropical Diseases, Mahidol University, Bangkok, Thailand during July 2011- June 2013 were reviewed.

Results: We found that headache and myalgia/arthalgia were found in most of the cases (182/198, 91.9%; 178/198, 89.9%, respectively). Epistaxis and hypermenorrhea were more common in children. Retro-orbital pain was more common in adult. The spontaneous bleeding tended to be more common in children than adults. DEN2 (48.9%) was the most common serotype followed by DEN3 (23.7%), DEN1 (22.2%) and DEN4 (5.2%). Regarding dengue serotypes, subjects infected with DEN1 had more shock, hypermenorrhea and epistaxis than others. Lymphadenopathy and rash during febrile stage were found in subjects infected with DEN2 only. Subjects infected with DEN4 infection had more retro-orbital pain and petechiae than others.

Conclusion: The results show secondary dengue infection was most common and the most prevalent dengue serotype was serotype 2. Typical symptoms in adult involved retro orbital pain, nausea and arthralgia while children might suffer epistaxis and hypermenorrhea. We also found that DEN 1 tended to have more mucosa bleeding and shock. In DEN 4 infection, subjects had more retro-orbital pain and skin bleeding.