Peripheral Smear, an Important Diagnostic Tool in the Diagnosis and Monitoring of Disease Activity in Dengue Fever, in Resource Limited Settings
Journal Title: Indian Journal of Pathology: Research and Practice - Year 2018, Vol 7, Issue 12
Abstract
Background: Dengue fever is the most common arbovirus infection in the world. Clinical manifestation range from fever to dengue shock syndrome (DSS). Clinical diagnosis can be difficult, as its presenting signs and symptoms can easily be confused with other febrile illnesses. Though specific diagnostic tests like NS1 antigen and dengue specific IgM antibody by immunochromatography are currently available for rapid diagnosis and early management in secondary and tertiary care centers, resource limited settings have problems with the early detection, due to non availability of such expensive diagnostic tests. Also, specific tests for monitoring the disease activity, has not come in to regular practice till date, in many parts of the world. Hence, in addition to early and accurate diagnosis, early markers of progression to severe disease are urgently needed. Aim of the study: To emphasize the importance of peripheral smear examination in the early assessment and monitoring of disease activity in patients with dengue fever. Methods: A prospective study of one year (January 2017 – December 2017), during which 132 patients with dengue fever (78 cases positive for NS1 antigen and 54 cases positive for anti Dengue IgM antibody), tested and confirmed by tests for NS1 antigen and Anti Dengue IgM antibody were selected for the study and their peripheral smears were simultaneously examined and the findings were noted and compared. The patients were followed up with serial platelet counts and band forms during their hospital stay. Results: The peripheral smear findings noted for all the 132 dengue positive patients were leucopenia (91%), neutropenia (89%), bandemia (80%), reactive lymphocytosis (95%) and thrombocytopenia (84%). There were 6 cases of dengue hemorrhagic syndrome and all such patients had very low platelet counts (<50000) and bandemia >15%. In all the cases, clinical improvement was consistently associated with rising platelet count along with clearance of band forms. Conclusion: These peripheral smear findings are consistently present in majority of the patients with dengue fever. Such findings can be considered for diagnosis and monitoring the disease activity of dengue fever, especially in resource limited settings for early diagnosis and effective management.
Authors and Affiliations
Muthukrishnan Ramachandran
Keywords
Related Articles
- EP ID EP532295
- DOI 10.21088/ijprp.2278.148X.71218.7
- Views 37
- Downloads 0
Fine Needle Aspiration Cytology and Histopathology Correlation of Breast Lesions in the District of Kanchipuram
Background: Breast carcinoma is the leading cause of death due to cancer in women. It is difficult to determine whether a lump is benign or malignant from clinical assessment. Fine needle aspiration cytology (FNAC) is a...
Study of Utility of p63 Immunohistochemical Stain to Differentiate Urothelial Carcinomas of Urinary Bladder from Adenocarcinomas of Prostate
Introduction: Cancer of the bladder and of prostate are commonmalignancies all over the world. In some cases it is difficult to point to the exact primary due to the anatomical location and morphology of the tumors from...
Comparative Study of Lipid Profile in Women Using Oral Contraceptive Pills Versus Non Oral Contraceptive Pills Users in Reproductive Age Group
Population explosion has posed a serious threat to the progress and survival of mankind. The Oral contraceptive pills (OCPs) quickly have become the most effective, acceptable and reversible contraceptive. OCPs contain a...
Comparative Study of Intrathecal Hyperbaric Bupivacaine, Hyperbaric Bupivacaine with Clonidine and Hyperbaric Bupivacaine with Magnesium Sulphate for Perioperative Pain Relief in Lower Limb and Infraumblical Surgeries
Background: Spinal anaesthesia is the primary anaesthetic technique for many types of surgery. Limiting the dose of local anaesthetic used in spinal anaesthesia has been an aggressive topic of study as it will achieve ra...
Spontaneous Bacterial Peritonitis: Diagnostic Importance of Ascitic Fluid Polymorphonuclear Cell Count, Biochemical and Microbiological Analysis
Introduction: Ascites represents the pathological collection of fluid in the peritoneal cavity. Spontaneous bacterial peritonitis is the infection of the ascitic fluid. For its diagnosis, the number of polymorphonuclear...