Abstract

Background: Dengue illness is a common devastating epidemic in pediatric population. Fever, Thrombocytopenia, hypovolemic shock and bleeding are the common manifestations. Platelet indices are now increasingly being reported by the haematology labs which has shown promise as predictor of bleeding. We have derived a composite index which has a potential to be a better predictor of bleeding in dengue illness.

Objective: Primary objective was to describe the clinic haematological profile in serologically proved dengue infection in children. Composite platelet index (CPLI) was calculated by multiplying platelet count (decimals) with Mean platelet volume. Material and methods: This was a retrospective study with data of children admitted for dengue illness collected between January 2015 and October 2015. We have studied a total of 117 children.

Results: Median (IQR) age was 9 (6-13) years. 34.1% of the patients had hypotension, 20% had bleeding manifestation and 2.4% developed haemorrhagic shock. Case fatality rate was 0.8%. 74.5% had thrombocytopenia. Both platelet and white cell counts were low in 30.9% of our patients. Median (IQR) CPLI in our patients was 13.5 (6.6-23.1) and in those with mucosal bleed or haemorrhagic shock was 6 (3-9.3).

Conclusion: About one quarter of pediatric dengue patients will not have thrombocytopenia at admission. Composite platelet index will be low in patients with mucosal bleeding or haemorrhagic shock.

Keywords: Pediatric dengue; Hematological profile; Composite platelet index