Can Radiology Play a Role in Early Diagnosis of Dengue Fever?

S. Chandak, Ashutosh Kumar
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引用次数: 12

Abstract

Background: Dengue fever (DF) is a viral hemorrhagic fever causing severe morbidity and mortality in affected patients. Aims: The purpose of our study was to evaluate the changing trends in radiological findings in DF, to find if ultrasound is useful in the diagnosis of DF during an epidemic in absence of serological tests, and also to investigate the effects of DF in pregnancy. Materials and Methods: A prospective study was conducted in 2013 comprising of 400 patients who were serologically positive for dengue. Out of these, radiological investigations were conducted for 107 patients who were analyzed. Results: Out of the 107 patients, 85 patients underwent ultrasound, 12 computed tomography (CT) scans of brain or paranasal sinuses, and 21 chest radiography. The maximum numbers of patients (79%) were in the age group of 20-50 years. The most common ultrasound finding was hepatomegaly that was seen in 62% of the patients. Other findings were splenomegaly (45%), gallbladder (GB) wall edema (45%), right-sided pleural effusion (37%), bilateral pleural effusion (22%), and ascites (36%). Out of 10 pregnant patients, 5 had oligohydramnios, 2 had intrauterine growth restriction, 2 had intrauterine fetal demise, and 5 had a normal antenatal ultrasound. Conclusion: Ultrasound findings of hepatosplenomegaly, GB wall edema, right-sided or bilateral pleural effusion, and ascites in patients presenting with signs and symptoms of DF during an epidemic are virtually diagnostic of DF. There have been recent changing trends with hepatosplenomegaly being the more common manifestation, in comparison to ascites and GB wall edema. DF also has catastrophic effects in pregnancy such as oligohydramnios and intrauterine fetal demise.
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放射学能在登革热的早期诊断中发挥作用吗?
背景:登革热(DF)是一种病毒性出血热,在感染患者中引起严重的发病率和死亡率。目的:我们研究的目的是评估DF的放射学表现的变化趋势,发现在没有血清学检查的情况下超声在DF的诊断中是否有用,以及调查DF在妊娠中的影响。材料和方法:2013年进行了一项前瞻性研究,包括400名登革热血清学阳性患者。其中,对107例患者进行了放射学检查。结果:在107例患者中,85例患者进行了超声检查,12例进行了脑或鼻窦CT扫描,21例进行了胸片检查。20-50岁年龄组的患者最多(79%)。最常见的超声发现是肝肿大,62%的患者可见。其他表现为脾肿大(45%)、胆囊壁水肿(45%)、右侧胸腔积液(37%)、双侧胸腔积液(22%)和腹水(36%)。10例妊娠患者中,羊水过少5例,宫内生长受限2例,宫内死胎2例,产前超声正常5例。结论:在流行期间出现DF体征和症状的患者,超声表现为肝脾肿大、GB壁水肿、右侧或双侧胸腔积液和腹水,实际上可以诊断DF。与腹水和GB壁水肿相比,肝脾肿大是更常见的表现。DF对妊娠也有灾难性的影响,如羊水过少和宫内胎儿死亡。
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