Clinical manifestations and hematological and serological findings in children with dengue infection

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Mulya Rahma Karyanti


Background Dengue hemorrhagic fever (DHF) is endemic to Indonesia and remains a public health problem, with its highest incidence in children. There have been few reports on the clinical, hematological and serological data in children \\lith dengue.

Objective To assess the clinical and laboratory profiles of children \\lith dengue infection in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Methods Clinical, hematological and serological infonnation from children diagnosed v.ith dengue infection in Cipto Mangunkusumo Hospital were collected from 2007 to 2009.

Results Of611 children admitted with dengue, 143 (23.4%) had dengue fever (DF), 252 (41.2%) had DHF grades I and II; and 216 (35.4%) had DHF grades III and IV. Of the 81 cases where dengue serotypes were identified, 12.3% were DENV1, 35.8% were DENV-2, 48.2% were DENV-3 and 3.7% were DENV-4. Mean age of subjects was 8.9 years (SD 4.4), and 48.4% of cases were boys. The mean length of fever before hospital admission was 4.2 days (SD 1.1) and mean length of stay in the hospital was 4 days (SD 2.7). Common symptoms observed were petechiae, hepatomegaly and epistaxis. Complications found mostly in those with dengue shock syndrome (DSS) were hematemesis (30 cases, 4.9% of all patients), encephalopathy (19 cases, 3.1 %) and melena (17 cases, 2.8%).

Conclusion Signs and symptoms of fever, bleeding manifestations and thrombocytopenia were present in children 'With DF and DHF, while signs of increased vascular permeability were found only in those 'With DHF. Encephalopathy and gastrointestinal bleeding were found mostly in DSS cases. At admission, leukopenia was found in more DF patients than in DHF patients. Absence of leukopenia may be a sign of more severe dengue infection. 

Article Details

How to Cite
Karyanti M. Clinical manifestations and hematological and serological findings in children with dengue infection. PI [Internet]. 30Jun.2011 [cited 6Dec.2021];51(3):157-2. Available from:
Received 2016-09-28
Accepted 2016-09-28
Published 2011-06-30


1. Halstead SB. Dengue. Lancet. 2007;370,1644,1652.
2. Chaturvedi UC, Shrivastava R. Dengue haemorrhagic fever: a global challenge. Indian) Med Microbiol. 2004;22,5,6.
3. Pere, )G, Clark GC, Gubler D), Reiter P, Sanders E), Vorndam A V. Dengue and dengue haemorrhagic fever. Lancet.1998;352.971,7.
4. Dengue for diagnosis, treatment, prevention and control. Geneva, WHO; 1997. p. 1,146.
5. Kittigul L, Pitakarnjanakul P, Sujirarat D, Siripanichgon K. T he difference of clinical manifestations and laboratorium findings in children and adults with dengue virus infection. ) Clin Virol. 2007;39,76,81.
6. Halstead SB. Dengue: overview and history. In: Halstead SB, Pasvol G, Hoffman L, editors. Dengue. 1st ed. Volume 5. Singapore: Imperial College Press; 200S. p.1􀁒2S.
7. Setiati TE, Wagenaar JFP, de Kruit MD, Mairuhu ATA, Van Gorp ECM, Soemantri A. Changing epidemiology of dengue haemorrhagic fever in Indonesia. Dengue bulletin. 2006;30,1,14.
S. Sapir DG, Schimmer B. Dengue fever: new paradigms for changing epidemiology. Emerging themes in epid. 2005;2,1,10.
9. Sumanno. Dengue haemorrhagic fever in Indonesia. Southeast
Asian) Trop Med Public Health. 1987; 18,269,74.
10. Gupta E, Dar L, Kapoor G, Broor S. T he changing epidemiology
of dengue in Delhi, India. Virol j. 2006;92,1,5.
11. Nathin MA, Harun SR, Sumanno. Dengue haemorrhagic fever and Japanese B encephalitis in Indonesia. Southeast Asian) Trop Med Public Health. 1988;19;475,81.
12. Kabra SK, Jain Y, Pandey RM, Madhulika T, Singhal p, Tripathi P, et al. Dengue haemorrhagic fever in children in the 1996 Delhi epidemic. Transaction Royal Society of Tropical Medicine and Hygiene. 1999:93:294􀁛8.
13. Malavige GN, Velathanthiri VGNS, Wijewickrama ES, Fernando S, Jayaratne SD, Aaskov J, et al. Patterns of disease among adults hospitalized \\lith dengue infections. Q J Med. 2006;99,299-305.
14. Hammond SN, Balmaseda A, Perez L, Tellez Y, Saborio SI, Mercado JC, et al. Differences in dengue severity in infants, children and adults in a 3􀁛year hospital􀁛based study in Nicaragua. Am) Trop Med Hyg. 2005;73,1063-1070.
15. Cunnnings DA, Iamsirithaworn S, Lessler JT, McDennott A, Prasanthong R, Nisalak A, et al. The impact of the demographic
transition on dengue in T hailand: insights from a statistical analysis and mathematical modeling. Plos Med. 2009:6:1􀁛8.
16. Lin CC, Huang YH, Shu PY, Wu HS, Lin YS, Yeh TM, et al. Characteristic of dengue disease in Taiwan: 2002􀁛2007. Am ) Trop Med Hyg. 2010;82;73 1-739.
17. Khan NA, A,har EI, El-Fiky S, Madani HH, Abuljadial MA, Ashshi AM, et al. Clinical profile and outcome of hospitalized patients during first outbreak of dengue in Makkah, Saudi Arabia. Acta Tropica. 2008;105,39-44.
18. Barnes WJ, Rosen L. Fatal hemorrhagic disease and shock associated with primary dengue infection on a pacific island. American Trop Med Hyg. 1974;23,495-506.
19. Sumarmo, Wulur H, Jahja E, Gubler DJ, Suharyono W, Sorensen K. Clinical observations on virologically confinned fatal dengue infections in Jakarta, Indonesia. Bull WHO. 1983;61:693-701.
20. Gubler DJ. Dengue and dengue hemorrhagic fever. Clinical Microbiology Reviews. 1998;110480-496.
21. Ahsunthornwattana NE, Euahsunthornwattana J, T hisyakorn U. Peripheral blood count for dengue severity prediction: a prospective study in Thai children. Pediatrics. 2008; 121:S127.