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Pediatría (Asunción)

On-line version ISSN 1683-9803

Abstract

ARCE, Manuel; LUGO, Silvina  and  PAVLICICH, Viviana. Clinical, Laboratory, and Therapeutic Characteristics of Infants and Children Hospitalized for Dengue Fever: a Comparative Study. Pediatr. (Asunción) [online]. 2014, vol.41, n.1, pp.17-23. ISSN 1683-9803.

Introduction: The most common motive for hospitalization due to dengue fever in children varies according to the age group While in school age children, alarm signs are cited, in infants age itself is a risk factor. Objective: To compare the clinical, laboratory, and management characteristics of infants and school-age children hospitalized with a diagnosis of dengue fever. Methodology: We conducted a cohort study in the emergency department of the Hospital General Pediatríco Niños de Acosta Ñu from January to May 2013 that included 120 hospitalized children with confirmed diagnoses of dengue fever, of whom 60 were under age 1 year and 60 were over age 5 years. The infants were hospitalized due to the age risk factor, and the school-age children due to alarm signs. Results: Progression to severe forms of the disease was similar in both age groups (34.5% versus 30% p: 0.08). School-age children showed greater frequency of abdominal pain (78.3% versus 3.3% p: <0.001), early signs of shock (65% versus 30% p: <0.001), and signs of bleeding (16.7% versus 1.6% p: 0.003), and remained febrile for longer periods (3.9 days ± 0.8 versus 2.6 ± 1 day p: <0.001). No difference was seen between groups in capillary leakage (31.7% versus 25% p: 0.41). The school-age children more frequently showed hemoconcentration on day 5 of disease (19% versus 1.7% p: <0.001), showed longer thrombocytopenia duration (55.6% versus 25% p: <0.001), and greater leukopenia during hospitalization compared to infants. Children over age 5 years more commonly required parenteral hydration (98.3% versus 58.3% p: <0.001). Only younger infants required intensive-care hospitalization (10/60:16.7%). Three infants received vasoactive agents due to shock refractory to fluids, 2 required transfusions of blood byproducts and 1 required colloid expansion (albumin). No school-age child required inotropic drugs, colloid expansion, or transfusion of blood byproducts. Conclusions: No difference was found in progression to severe forms of dengue between children under age 1 without other risk factors and older children with alarm signs at hospitalization.

Keywords : Dengue fever; clinical characteristics; laboratory results; infants; children; school-age.

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