Print version ISSN 0123-9392
SALGADO, Doris Martha et al. Dengue hemorrhagic fever mortality in children: beyond shock. Infect. [online]. 2008, vol.12, n.1, pp. 21-27. ISSN 0123-9392.
Unusual clinical manifestations such as hepatitis, encephalitis, myocarditis and even death might be associated to the severe forms of dengue hemorrhagic fever. Aim: To describe mortality cases in children younger than 13 years of age at the Hospital Universitario in Neiva, Colombia. Design: Descriptive study with retrospective collection of data. Place: Neiva, Huila, Colombia. Population: Children younger than 13 years of age. Measurements: All death patients with diagnosis of dengue hemorrhagic fever from 2000 to 2006 were registered; clinical variables and laboratory data were analyzed by age groups by using non parametric tests. Results: Out of 1,448 patients with dengue hemorrhagic fever, 338 were admitted to the Pediatric Intensive Care Unit with 15 deaths (lethality 1.03%); 40% of admissions were in state III whereas 60% in state IV. Gastrointestinal symptoms and vascular leakage signs were present in 100% of cases. There was a higher tendency to hypotension, fewer platelet counts and higher serum transaminases in children between 1 to 5 years; there were no statistical differences between variables in none of the groups. Nine patients died as a consequence of acute myocarditis (60%) with heart rhythm alterations, from which two had elevated serum transaminases; three died because of acute hepatitis (20%) and three died with disseminated vascular coagulation (20%). Conclusion: Mortality associated to dengue hemorrhagic fever is not only due to hypovolemic shock and currently, other organs such as liver and myocardium might be target of the disease.
Keywords : dengue haemorrhagic fever; myocarditis; hepatitis.