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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Analysis of Clinical and Laboratory Alterations Related to Dengue Case Severity: Comparison between Serotypes 2 and 4 in Brazil
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Analysis of Clinical and Laboratory Alterations Related to Dengue Case Severity: Comparison between Serotypes 2 and 4 in Brazil

机译：与登革热病例严重相关的临床和实验室改变分析：巴西血清型2和4的比较

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摘要

The increase in severe dengue (SD) cases has caused great impact on public health and has concerned authorities of countries where the disease is endemic and epidemics reach high proportions. The recognition of progression signs of this severe disease during the initial febrile phase can be difficult, since the symptoms are often indistinguishable from other febrile diseases. The aim of this study was to evaluate the clinical manifestations and laboratory findings in patients from two dengue outbreaks and their association with the disease. The study was conducted in patients (n = 153) with signs and symptoms consistent with dengue occurred during two distinct epidemics, 2010 and 2013, in the city of Campos dos Goytacazes, Rio de Janeiro, Brazil. According to the 2009 World Health Organization criteria, patients were classified as dengue without warning signs ([ DwoWS] 60.6%, 57/94), dengue with warning signs ([ DwWS] 30.9%, 29/94), and SD (4.25%, 4/94). Patients with DwWS/SD presented lower platelet and leukocyte counts and higher transaminase levels when compared with the DwoWS ones. Interestingly, patients from the epidemic of 2010 caused by dengue virus 2 (DENV-2) had lower platelet counts than patients of the 2013 epidemic caused by DENV-4. Furthermore, plasma leakage, gastrointestinal bleeding, and pleural effusion, hallmarks for a more severe disease, were also more frequently observed in those cases. Although previous studiesmayhave extensively reported the wide range of the clinical aspects of dengue, the characterization of DENV-4 is desirable considering the burden of the disease during epidemics, especially for the health units and hospitals performing patient's management.
机译：严重登革热（SD）案件的增加对公共卫生产生了很大的影响，并有涉及疾病流行和流行病的国家的当局达到高比例。在初始发热期期间，识别这种严重疾病的进展迹象可能是困难的，因为症状往往与其他发热疾病难以区分。本研究的目的是评估两种登革热爆发的患者临床表现和实验室发现及其与疾病的关系。该研究在患者（n = 153）中进行了症状和症状，符合登革热在巴西的Campos Dos Goytacazes城市，2010年和2013年。根据2009年世界卫生组织标准，患者被归类为登革热，没有警告标志（[DWOWS] 60.6％，57/94），登革热带有警告标志（[DWWS] 30.9％，29/94）和SD（4.25％ ，4/94）。与DWOWS ONE相比，DWWS / SD患者呈现较低的血小板和白细胞计数和更高的转氨酶水平。有趣的是，2010年流行病的患者由登革热病毒2（Denv-2）较低​​的血小板计数比Denv-4引起的2013年疫情的患者。此外，在这些病例中也更常见地观察到血浆泄漏，胃肠出血和胸腔积液，具有更严重的疾病的标志。尽管以前的研究是广泛报告了登革热的广泛临床方面，但丹佛4的表征是考虑到流行病中疾病的负担，特别是对于执行患者管理的健康单位和医院。

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