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Target Concepts:
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Query: UMLS:C0038002 (
splenomegaly
)
9,873
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
An epidemic of
dengue
hemorrhagic fever occurred in Delhi during 1988. A total of 21 pediatric patients with that illness or
dengue
shock syndrome were evaluated from September-November 1988. All patients had fever, restlessness, ecchymotic spots, and ascites. Pleural effusion occurred in 19 patients (90%) and 18 (86%) exhibited each of the following: vomiting, thrombocytopenia, and hemoconcentration. Hepatomegaly was observed in 15 patients (71%) and
splenomegaly
in 3 (14%). Titers of hemagglutination inhibition (HI) antibodies against
dengue
virus type 2 were raised in all 15 cases from whom sera were collected during the acute stage. Convalescent sera from 5 patients had increased titers of HI antibodies to
dengue
virus type 2. The remaining 10 cases exhibited raised IgM antibody levels against
dengue
virus type 2. The fatality rate for serologically proven cases was 13% (2 of 15 patients) while for all patients (including those diagnosed clinically [n=6] and serologically [n=15]), it was 33.3% (7 of 21). Patients who survived had no sequelae, except 1 who had transient hypertension which continued for 2 weeks.
...
PMID:Dengue haemorrhagic fever in children in Delhi. 156 74
Southern Taiwan experienced a
dengue
(type 1) outbreak in the autumn of 1988. One hundred and thirteen febrile patients suspected as having
dengue
infection were seen in the emergency room of the Kaohsiung Medical College Hospital. These patients were recruited for this study. Two hundred and eighty-six sequential serum aspartate transaminase (AST) and alanine transaminase (ALT) data from these patients were analyzed. Data analysis showed serum AST had increased daily and all data were out of normal range from day 6 of the illness. Compared to the AST level on the first day of the illness, the AST level was noted to elevate to an average of 9.25 folds on day 6. The sequential changes of AST were as follows: AST had elevated since the third ill-day in most cases and reached a peak on the 7th or 8th ill-day. It then declined gradually from the 8th ill-day and became normal about 3 weeks later. The changes of ALT level were about the same as AST but had later onset and lower peak. Abdominal sonographic examinations showed thickening of the gall bladder wall,
splenomegaly
and ascites in some patients during acute stage of the illness and recovered completely after patients recovered from the
dengue
attack. The sequential change of serum transaminase levels and sonographic findings were compatible. These findings may be used as a reference for the differential diagnosis among
dengue
fever, acute hepatitis and acute cholecystitis.
...
PMID:Sequential changes of serum transaminase and abdominal sonography in patients with suspected dengue fever. 221 70
We report on a tourist returning from Thailand, who presented with classical
dengue
fever. While in Thailand a 36-year-old Swiss female laboratory assistant suddenly developed fever, devastating headache, retro-ocular pain, myalgia and arthralgia, photophobia, nausea and diarrhea. In addition she suffered from epistaxis, urogenital and skin bleeding, and a morbilliform exanthema. After her return to Switzerland we noted lymphadenopathy and
splenomegaly
, enanthema and laboratory findings of mild hepatitis, thrombocytopenia and leukopenia. The diagnosis of
dengue
virus infection was verified serologically. Apart from a long lasting convalescent asthenia we observed restitutio ad integrum within days under symptomatic therapy. Epidemiological clinical and diagnostic aspects of
dengue
virus infection are discussed.
...
PMID:[Imported dengue fever following a stay in the tropics]. 842 57
In a prospective study, the relationship between the clinical severity of
dengue
haemorrhagic fever (DHF) and the sonographic findings was examined. The study comprised 73 cases classified as mild (grades I-II) and 75 as severe (grades III-IV). Ultrasonography in the mild group revealed pleural effusions in 30%, ascites in 34%, gallbladder wall thickening in 32%, hepatomegaly in 49%,
splenomegaly
in 16%, and pancreatic enlargement in 14%. In the severe group, pleural effusions, ascites and gallbladder wall thickening were found in 95%, pararenal and perirenal fluid collections in 77%, hepatic and splenic subcapsular fluid collections in 9%, pericardial effusion in 8%, hepatomegaly in 56%,
splenomegaly
in 16%, and pancreatic gland enlargement in 44%. Ultrasound may be useful for early prediction of the severity of DHF in children.
...
PMID:Dengue haemorrhagic fever: ultrasound as an aid to predict the severity of the disease. 942 64
Sera were collected from a total of 122 children, comprising 117 cases with undifferentiated fever and 5 cases with
dengue
hemorrhagic fever (DHF), during June to September 1994 in Karachi, Pakistan. Sera were tested by the IgM-capture ELISA using
dengue
type 1 (D1),
dengue
type 2 (D2), West Nile (WN), and Japanese encephalitis (JE) viral antigens. Among 92 single sera from undifferentiated fever cases, IgM antibodies were detected in 5 cases by D1, 8 cases by D2, and 5 cases by WN antigens, respectively. Corresponding number of positives among 25 paired sera from undifferentiated fever cases were 3 by D1, 6 by D2, and 1 by WN antigen. Four out of 5 DHF cases possessed anti-D1 as well as anti-D2 IgM antibodies. Only a single DHF case was positive for anti-WN IgM antibodies. Anti-JE IgM antibodies were not detected in any of the tested serum specimens. Clinical manifestations of undifferentiated fever patients were generally non specific, but the percentage of children with anemia, hepatomegaly and
splenomegaly
was higher in patients possessing anti-
dengue
IgM antibodies than those without. Among the groups with anti-
dengue
IgM antibodies, those possessing only anti-D2 but not anti-D1 IgM antibodies showed higher percentages with cough, edema, and
splenomegaly
. The results indicated that up to 26% of the undifferentiated fever cases were caused by
dengue
virus infection in Karachi, Pakistan.
...
PMID:Dengue virus infection among children with undifferentiated fever in Karachi. 1077 30
This paper describes the clinical findings in 206 patients with
dengue
fever (DF) or with
dengue
hemorrhagic fever (DHF) during the epidemic of 1996 at Lucknow. The age group affected most was 11 to 30 years and 21% of the patients were less than 10 years old. The male:female ratio was 1.9:1. The onset was abrupt in all the patients, severe frontal headache was observed in 97%, myalgia in 90%, skin rash in 40%, vomiting in 29% and arthralgia in knee and hip joints in 9%. Anuria was seen in two patients. Lymphadenopathy was noted in 14%, hepatomegaly in 4%, being associated with mild jaundice in one patient, and
splenomegaly
in 2% of the patients. Involvement of the heart and lungs was seen in one patient each and no case with encephalitis was recorded. Hemorrhages from various sites were observed in 54% patients and 17 patients had profound shock. The commonest bleeding site was gums. Profound shock was preceded by various warning signs, the commonest being sudden hypotension. Among the patients with profound shock the mortality was 47% while the overall fatality rate was 3.8%. A number of the risk factors existed for a long time in this part of the world, but what precipitated the present epidemic at this time, is not known.
...
PMID:A clinical study of the patients with dengue hemorrhagic fever during the epidemic of 1996 at Lucknow, India. 1092 68
We reviewed 232 consecutive patients admitted to a tertiary-care hospital under the care of an infectious diseases unit for management of febrile illness acquired overseas. A total of 53% presented to hospital within 1 week of return and 96% within 6 months. Malaria was the most common diagnosis (27% of patients), followed by respiratory tract infection (24%), gastroenteritis (14%),
dengue
fever (8%), and bacterial pneumonia (6%). Pretravel vaccination may have prevented a number of admissions, including influenza (n=11), typhoid fever (n=8) and hepatitis A (n=6). Compared to those who had not traveled to Africa, those who had were 6 times more likely to present with falciparum than nonfalciparum malaria. An itinerary that included Asia was associated with a 13-fold increased risk of
dengue
, but a lower risk of malaria. Palpable
splenomegaly
was associated with an 8-fold risk of malaria and hepatomegaly with a 4-fold risk of malaria. As a cause of fever, bacterial pneumonia was > or =5 times more likely in those who were aged >40 years.
...
PMID:Fever in returned travelers: review of hospital admissions for a 3-year period. 1148 83
This study was performed to find out whether ultrasound is an important adjunct to clinical and laboratory profile in diagnosing
dengue
fever or
dengue
haemorrhagic fever and to further determine whether ultrasound is useful in predicting the severity of the disease. Ultrasound was performed on 128 patients (2-9 years) with clinical suspicion of
dengue
fever. Serological tests were performed to confirm the diagnosis. 40 patients were serologically negative for
dengue
fever and later excluded from the study. Of the remaining 88 serologically positive cases, 32 patients underwent ultrasound on second to third day, repeated on fifth to seventh day of fever and in 56 patients ultrasound was done only on fifth to seventh day of fever. Of the 32 patients who underwent the study on second to third day of fever, all showed gall bladder wall thickening and pericholecystic fluid, 21% had hepatomegaly, 6.25% had
splenomegaly
and right minimal pleural effusion. Follow-up ultrasound on fifth to seventh day revealed ascites in 53% left pleural effusion in 22% and pericardial effusion in 28%. Of the 56 patients who underwent the study on fifth to seventh day of fever for the first time all had gall bladder wall thickening, 21% had hepatomegaly, 7% had
splenomegaly
, 96% had ascites, 87.5% had right pleural effusion, 66% had left pleural effusion and 28.5% had pericardial fluid. To conclude, in an epidemic of
dengue
, ultrasound features of thickened gall bladder wall, pleural effusion and ascites should strongly favour the diagnosis of
dengue
fever.
...
PMID:Role of ultrasound in dengue fever. 1584 34
A comparative study of
dengue
hemorrhagic fever in infants and children was conducted at the Department of Pediatrics, Phetchabun Hospital between May,1999 and December, 2002. There were 1,924 DHF patients (aged 0-14 years). There were 40 (2.1%) infants (age 0-l years) and 27 (1.4%) young children (age 1-2 years). Sixty-seven cases (3.5%) of the older children (> 2-14 years) were selected to be compared. The clinical and epidemiological data for each of the three groups were not statistically different from each other, except for age,
splenomegaly
, shock state and mode of
dengue
infection. Older children were more likely to have a second
dengue
infection and a shock state than younger patients. Laboratory investigation results and fluid management for each of the three groups were not significantly different from each other except for the total WBC (min), neutrophils (max), lymphocytes (max) and platelets (min). The platelets (min) in the infants were significantly lower than in the younger children and the older children. Associated symptoms, diseases, complications, and hematologic manifestations in each of the three groups were not significantly different from each other except for the presence of coryza, seizures, nausea/vomiting, rash, and petichiae. Coryza, seizures, nausea/vomiting, rash, and petichiae in the infants and younger children were significantly different from the older children.
...
PMID:DHF in infants, late infants and older children: a comparative study. 1629 42
Dengue fever
(DF) and Dengue hemorrhagic fever (DHF) are widespread in Southeast Asia. An outbreak of DF/DHF in Delhi in 2003 started during September, reached its peak in October-November, and lasted until early December. This study describes the clinical and laboratory data of the 185 cases of DF/DHF admitted to Lok Nayak Hospital, New Delhi. The mean age of the patients was 26 +/- 10 years. Fever was present in all the cases with an average duration of fever being 4.5 +/- 1.2 days with headache (61.6%), backache, (57.8%), vomiting (50.8%) and abdominal pain (21%) being the other presenting complaints. Hemorrhagic manifestations in the form of a positive tourniquet test (21%), gum bleeding and epistaxis (40%), hematemesis (22%), skin rashes (20%) and melena (14%) were also observed. Hepatomegaly and
splenomegaly
were observed in 10% and 5% of cases, respectively. Laboratory investigations revealed thrombocytopenia (with a platelet count of < 100,000/microl) in about 61.39% of cases, Leukopenia (WBC <3,000/mm2) and hemoconcentration (Hct >20% of expected for age and sex) were found in 68% and 52% of the cases, respectively. The mortality rate was 2.7%. Despite widespread measures taken to control outbreaks of DF, it caused major outbreaks. More stringent measures in the form of vector control, improved sanitation and health education are needed to decrease morbidity, mortality and health care costs caused by a preventable disease.
...
PMID:The 2003 outbreak of Dengue fever in Delhi, India. 1643 42
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