PURPOSE: The Dengue is an acute febrile infectious syndrome, which is one of the most common mosquito-borne viral diseases in tropical areas. In Venezuela we are known to have all the serotypes (Den-1, Den-2, Den-3 and Den-4) constantly cycling and maintaining a dengue fever to dengue hemorrhagic fever ratio of 10:1, with a mortality rate of 0,63%. In Dengue Hemorrhagic fever, among the clinical manifestations, there could appear pleural-pulmonary complications. Our study was intended to recognize the pleuro-pulmonary complications present in a cohort of patients known with the diagnosis of dengue infection, who were evaluated and treated in our Institution.
METHODS: Out of a 100 demonstrated cases of Dengue infection, admitted in our Hospital within the period from November 2006 to November 2007, 47 were determined to be of the clinical form of Dengue hemorrhagic fever (according to WHO criteria). Within this group, the prevalence of pleural-pulmonary complications was determined by clinical symptoms, signs, chest X-ray, Thoracic CT scanning, and pleural fluid analysis.
RESULTS: The mean age was 40 years, 34 % were females, and 64% were males. The most common clinical manifestations were fever (100%), malaise (82%), myalgia (53%) and arthralgia (51%); meanwhile respiratory symptoms (dyspnea and coughing) were seen in 10 patients (21%), 6 of which were eventually diagnosed with pleural effusions (13%). The chemical characteristics of pleural fluid was of an exudates with a mean protein value of 4,3 gr %, a mean cellular count of 400 cell per mm3 with a mononuclear predominance of 70%.
CONCLUSION: Although scarce, the dengue fever can induce pleural pulmonary complications. This may be due to an increase in vascular permeability induced by the virus inflammatory response.
CLINICAL IMPLICATIONS: It is very important to conduce a prospective and large trial of patientes wit Dengue Hemmorrhagic Fever in order to know the physiological and clinical pleuro-pulmonary consequences of this endemical disease.
DISCLOSURE: Jose Isea-Dubuc, No Financial Disclosure Information; No Product/Research Disclosure Information