Clinical manifestations of dengue haemorrhagic fever in children in Bandung, Indonesia.

A Chairulfatah, D Setiabudi, A Ridad, R Colebunders
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Abstract

To describe the clinical manifestations of dengue haemorrhagic fever (DHF) all children with a clinical diagnosis of DHF admitted to the paediatric ward of the Dr. Hassan Sadikin General Hospital (Bandung, Indonesia) between April 1st 1991 and September 30th 1993 were enrolled in a prospective study. Of the 306 children with a clinical diagnosis of DHF on admission in only 128 (41.8%) the diagnosis of DHF was confirmed by HI test. Of the confirmed cases, 24 (19%) developed shock and 1 (0.7%) died. Of the 174 cases with a negative HI test, 33 (19%) developed shock and 4 (2%) died. Four of the children died of shock before an hemagglutination inhibitor (HI) test was performed. The overall case mortality rate was 2.9%. The symptoms and signs of the 128 children with serologically confirmed DHF included fever or a history of fever (100%), petechiae (29.7%), epistaxis (39.1%), other forms of bleeding (5.5%), a positive Tourniquet test (78.1%), hepatomegaly (46.9%), epigastric pain (61.7%), vomiting (55.5%), thrombocytopenia < 100,000/mm3 (3.2% on admission and 15.3% during hospitalisation). Four (3%) children developed encephalopathy and 1 child an acute liver failure. In order to decrease the mortality associated with DHF early diagnosis and adequate case management are essential.

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印度尼西亚万隆儿童登革出血热的临床表现。
为了描述登革出血热(DHF)的临床表现,1991年4月1日至1993年9月30日期间,Hassan Sadikin医生总医院(印度尼西亚万隆)儿科病房收治的所有临床诊断为登革出血热的儿童被纳入了一项前瞻性研究。入院时临床诊断为DHF的306例患儿中,仅有128例(41.8%)通过HI检测确诊DHF。在确诊病例中,24例(19%)发生休克,1例(0.7%)死亡。在174例HI阴性病例中,33例(19%)发生休克,4例(2%)死亡。其中4名儿童在进行血凝抑制剂(HI)试验前死于休克。总病死率为2.9%。128例血清学确诊DHF患儿的症状和体征包括发热或发热史(100%)、瘀点(29.7%)、鼻出血(39.1%)、其他形式出血(5.5%)、止血带试验阳性(78.1%)、肝肿大(46.9%)、胃脘痛(61.7%)、呕吐(55.5%)、血小板减少< 100,000/mm3(入院时3.2%,住院时15.3%)。4名(3%)儿童出现脑病,1名儿童出现急性肝功能衰竭。为了降低与登革出血热相关的死亡率,早期诊断和适当的病例管理至关重要。
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