Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To determine the magnitude of the problem posed by primary dengue infection in children and the distinctive clinical clues that may differ from those with secondary infection, 996 children serologically diagnosed with dengue infection and admitted to the Department of Pediatrics, Chulalongkorn Hospital, Bangkok, Thailand between 1988 and 1995 were retrospectively reviewed. One hundred and thirty-nine cases (14.0%) were serologically proved to be primary dengue infection. Of these, 72 were males and 67 were females, with a mean age of 4.8 years. Common manifestations by order of frequency included fever (97.8%), hepatomegaly (71.9%), vomiting (59.0%), decreased appetite (55.4%), coryza (52.5%), drowsiness (39.6%), diarrhea (34.5%), rash (33.8%), abdominal pain (23.0%) and seizure (15.8%). The mean duration of fever before admission was 4.6 days. Common sites of bleeding were skin (41.7%), mucous membrane (14.4%) and the gastrointestinal tract (12.2%). Clinical diagnosis was categorized into dengue fever (22.3%), dengue hemorrhagic fever (60.4%) and dengue shock syndrome (17.3%). Three patients (2.2%) died. Compared with the children with secondary dengue infection (n=139), children with primary dengue infections tended to be younger, presented more commonly with coryza, diarrhea, rash and seizure; and less commonly with vomiting, headache and abdominal pain (p < 0.05). The maximal hematocrit level, the mean difference between maximal and minimal hematocrit values and the maximal percentage of neutrophils were significantly lower in the study group, whereas the maximal percentage of lymphocytes was significantly higher. Dengue fever was more common and dengue shock syndrome was less common in the study group (p < 0.05). This study has emphasized that primary dengue infection is not uncommon and is less severe than secondary infection. Clinical presentations and laboratory findings are somewhat different between the two conditions.
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PMID:Primary dengue infection: what are the clinical distinctions from secondary infection? 1194 2

A report of 19 cases of serologically-proven dengue hemorrhagic fever (DHF) in infants aged 3-12 months who were admitted to the Department of Pediatrics, Chon Buri Regional Hospital, Thailand, during 1995 to 1998. Subjects were 8 males and 11 females, with the peak age of 8 months. Four cases (21%) had DHF and other common co-infections ie pneumonia (2 cases), Staphylococcus aureus sepsis (1 case) and Haemophilus influenzae meningitis (1 case). The clinical manifestations of the 15 DHF cases were high fever (100%), coryza (93.3%), hepatomegaly (80%), drowsiness (53.3 %), and vomiting (46.7%); rash was observed in only 27%; one-fifth developed febrile convulsions. Sites of bleeding were the skin (petechiae) 58%, gastrointestinal system (melena) 16%, and mucous membrane (epistaxis) 5%; thrombocytopenia and increased hematocrit (> or =20%) were noted in 95% and 84% respectively. The majority of the patients (18 cases, 95%) had primary infection; only one (5%) had secondary infection. The clinical severity of the DHF was Grade I, II, and III (dengue shock syndrome) in 21%, 47% and 32% of cases respectively. After appropriate and effective management, all the infants recovered fully.
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PMID:Dengue hemorrhagic fever in infants. 1211 60