Clinical presentations and laboratory findings in suspected cases of dengue virus

OBJECTIVE: To study the clinical presentations and laboratory findings of patients presented with fever in a Hospital in Portsudan, Sudan and to detect dengue virus antibodies in their blood.

METHODS: This study was carried in Almwani Hospital during the period from April to July 2005. Eighty-four patients were included in this hospital-based study. All of them had fever. Their blood films, Widal tests for typhoid, stools and urine investigations were normal. The clinical data were collected using questionnaires. Two samples of blood were taken. One was for general hematological investigation (white blood cell and platelets count), while serum was taken from the other sample for serological detection of the dengue virus antibodies using the enzyme-linked immunosorbent assay (ELISA) technique.

RESULTS: The fever was associated with vomiting (22 patients) and abdominal pain (44 patients). In 93% of the cases bleeding (epistaxes, purpura, malena, hematemesis, and others) occurred. Routine laboratory findings were leucopenia (90% of the cases) and thrombocytopenia (88% of the cases). The diagnosis was confirmed by ELISA detection of dengue virus immunoglobulin M antibodies (in 88% of the patient's sera).

CONCLUSION: In endemic areas with mosquitoes such as Aedes aegypti, infection with dengue virus should highly be suspected in patients presented with fever. The ELISA or rapid tests for detection of the viral antibodies should be added to the routine investigations to any patient with complain of fever with no obvious cause. Surveillance program and mosquito control measures should be activated in Portsudan.