Comparison of Clinical and Biochemical Characteristics Between Dengue Fever and Dengue Hemorrhagic Fever in Pediatric Patients

Open Access

Abstract

Background: Dengue infection in children has a broad clinical spectrum, ranging from uncomplicated dengue fever (DF) to dengue hemorrhagic fever (DHF), which may progress to shock and severe organ involvement. Early identification of clinical and laboratory features associated with DHF is important for timely management. Methods & Materials: This prospective longitudinal study was conducted among confirmed dengue patients aged 1 month to 12 years admitted to the Department of Pediatrics, Dhaka Medical College Hospital, Dhaka, Bangladesh, from January to December 2022. After ethical approval and informed consent, 350 eligible children were included. Clinical, hematological and biochemical characteristics were compared between DF and DHF groups. Data were analyzed using SPSS version 23.0. Results: Among 350 children, 133 (38%) had DF and 217 (62%) had DHF. Urban residence was more common among DHF patients (161 vs. 14; p=0.001). Skin rash was more frequent in DF (119 vs. 49; p<0.001), whereas vomiting (119 vs. 49; p=0.001) and hepatomegaly (103 vs. 21; p=0.002) were more common in DHF. Low urine output, low pulse volume and shock were significantly associated with DHF (p=0.001, p=0.006 and p=0.001, respectively). Raised hematocrit, leukopenia and thrombocytopenia were significantly more frequent in DHF (p<0.004, p<0.001 and p<0.001, respectively). Elevated ALT and AST were also significantly more common in DHF (both p<0.001). Conclusion: DHF showed more severe clinical, hematological and biochemical abnormalities than DF. Early recognition of these features may facilitate timely intervention and reduce complications.