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ABSTRACT: Dengue fever (DF), which was considered a rare disease entity in Nepal till the recent past, showed a major outbreak in the central part of the country in 2010. This study was aimed at finding the clinical and laboratory profiles of DF patients during the outbreak in Chitwan and adjacent districts. Among the 1456 patients with acute febrile illness, 426 (29%) tested positive for DF, out of which 414 patients were included in the study. 85% of the patients were in the 16–60 years age group and males (58%) outnumbered females (42%). 56% of the patients came from the urban area while 34% and 10% came from sub-urban and rural areas, respectively. 69% of the patients tested positive for IgM, 10% tested positive for IgG only and 21% tested positive for both IgG and Igm. The most common clinical presentations were fever (100%), headache (97%), bodyache (93%),nausea (85%) and vomiting (63%). Other symptoms included retro-orbital pain (49%), itching (43%), abdominal pain (42%), skin rashes (27%) and loose motion (26%). Pneumonia was seen in 10% of patients. 90% of patients were admitted in hospital and 3% required ICU admission. Around 10% of patients were managed as outpatients. Dengue fever (DF) and dengue haemorrhagic fever (DHF) were present in 79% and 21% of the patients, respectively. Only 2 out of 414 patients had dengue shock syndrome (DSS). Thrombocytopenia (platelet count less than 100 000 mm3) was present in 70% of patients and 18% of patients had platelet count less than 50 000 mm3. Leucopaenia was seen in 54% of patients. The most common ultrasound finding was hepatomegaly (31%) followed by thickened gall-bladder wall and ascites (12% each), splenomegaly (9%) and pleural effusion (8%). Only one patient with DHF who had co-morbidity with bronchiectasis and alcoholic liver disease died in the hospital during the course of treatment.
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