Sonographic findings in grade III dengue hemorrhagic fever in adults

Abstract

Purpose: Sonography has been used to evaluate children with dengue hemorrhagic fever, but to our knowledge no such studies have been conducted with adults. We present the sonographic findings in 40 adults with severe (grade III) dengue hemorrhagic fever (DHF). Methods: Forty patients (30 men and 10 women, aged 16-65 years) given a presumptive diagnosis of grade III dengue hemorrhagic fever during a documented regional epidemic underwent abdominal sonography. Ten also underwent chest radiography. Serologic confirmation was obtained in 5 patients, and in the rest the diagnosis was based on epidemiologic and clinical findings. Results: Sonographic findings included pleural effusion in 21 patients (53%), thickening of the gallbladder wall in 17 (43%), and mild ascites in 6 (15%). These findings were similar to those of previous studies of severe DHF in children, although the incidence of pleural effusion and ascites was slightly lower in our series. Neither pleural effusion nor ascites was apparent on clinical examination. Of the 10 patients who underwent both sonography and chest radiography, sonography detected pleural effusion in all 10, whereas radiography detected it in only 3. Conclusions: Sonographic findings in DHF in adults (pleural effusions, ascites, and gallbladder wall thickening) were similar to those described for children but seem to be of lesser severity. Abdominal sonography is a useful diagnostic tool for confirming suspected cases of DHF. Sonography was found to be superior to chest radiography in detecting pleural effusions in the 10 patients in whom radiographs were available.