Muhammad Khurram, Wajeeha Qayyum, Muhammad Faheem, Muhammad Umar, Hamama Tul Bushra, Matti Ullah Khan, Nimra Khan.
Characteristics of dengue shock syndrome during 2014 dengue epidemic in Rawalpindi, Pakistan.
Rawal Med J Jan ;41(2):142-7.

Objective: To study the characteristics of dengue shock syndrome (DSS) patients managed during Rawalpindi dengue epidemic 2014. Methodology: This observational study was conducted at Dengue Ward of Holy Family Hospital, Rawalpindi, Pakistan during epidemic. Patients fulfilling Dengue Expert Advisory Group (DEAG) criteria for DSS were included. Data regarding patient characteristics, clinical features, diagnostic basis, laboratory parameters, treatment, and outcome were noted. Result: Out of 25 patients, 52% were male. Mean patient age was 26.8±11.52 years. Mean duration of pre hospitalization illness was 5.4±1.5 days. Vomiting, aches, and headache were frequently noted symptoms. Mean day of illness at which DSS developed was 5.7±2.04 days. 24% had additional illnesses. 56% had secondary infection. 84% were PCR positive for DEN3. At admission, mean TLC, platelets, and hematocrit were 3.68x103microL, 60.5x103 microL and 39.61%, respectively. 96% had ultrasonographic leak. Alanine transferase was deranged in 59% and Aspartate transferase in 86.66% . Mean amount of intravenous fluids administered was 5011.33 ±1754.24 ml. 60%, and 28% received Dextran and blood transfusion, respectively. One patient expired. Mean duration of hospital stay was 5.08±1.28 days. Conclusion: Young adults who had DEN-3 infection suffered from DSS this dengue epidemic. Primary infection was frequently noted in these patients. Mortality in these patients was 4%.

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