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Abstract：
Introduction Dengue fever, caused by the dengue virus transmitted by Aedes aegypti mosquitoes, is a significant public health concern globally. Its resurgence in recent years, particularly in low- and middle-income countries, has led to increased morbidity and mortality rates. Atypical manifestations, involving the cardiac, liver, gut, renal, blood, bone, nervous, and respiratory systems, in dengue, can complicate both diagnosis and management. This study aimed to investigate the incidence of lung manifestations in dengue-infected individuals and their correlation with patient outcomes. Background The prevalence of dengue fever has risen dramatically over the past two decades, with Asia bearing the brunt of the burden, particularly India. The pathophysiology of lung complications in dengue remains unclear but is thought to be related to capillary leak syndrome and thrombocytopenia. Studies suggest that respiratory symptoms may be associated with severe cases and increased mortality rates. Despite limited research in India, understanding lung manifestations in dengue is crucial for improving diagnostic accuracy and patient care. Methods A retrospective study was conducted at K.S. Hegde Hospital, a tertiary care facility located in Mangalore, India, involving patients aged 18 years and above diagnosed with dengue fever between January and December 2019. Data gathered comprised patient demographics, clinical symptoms, laboratory findings, imaging results including radiographs, computed tomography (CT) scans of the chest (if accessible), ultrasound examinations of the chest and abdomen, and 2D echocardiograms, as well as patient outcomes. Diagnosis of lung manifestation was established through clinical assessment, chest X-ray interpretation, and ultrasound of the chest. Statistical analysis was conducted using SPSS Statistics (version 20), with a significance set at p<0.05. Results Out of 255 dengue cases, 10.19% (n=26) exhibited pulmonary manifestations, with pleural effusion being the most common. Older age (>50 years) and comorbidities were associated with a higher incidence of lung involvement. Respiratory symptoms, such as breathlessness, were more prevalent in patients with pulmonary complications. Laboratory parameters indicated distinct profiles in patients with lung manifestations, including elevated total count, urea, bilirubin, and liver enzymes, and reduced platelet counts. Mortality rates were higher in patients with lung involvement, older age, and comorbidities. Discussion The study findings highlight the importance of recognizing respiratory symptoms in dengue fever, particularly in older patients and those with underlying health conditions. The association between pulmonary involvement and adverse outcomes underscores the need for early detection and appropriate management strategies. Future research should focus on elucidating the pathophysiology of lung complications in dengue and developing targeted interventions to improve patient outcomes. Conclusion Lung manifestations in dengue fever represent a significant clinical challenge and are associated with increased morbidity and mortality. Early recognition of respiratory symptoms, along with prompt diagnostic evaluation and appropriate management, is essential for improving patient prognosis. Further studies are warranted to deepen our understanding of lung involvement in dengue and optimize therapeutic approaches to mitigate its impact on patient outcomes.
摘要：
介绍登革热，由埃及伊蚊传播的登革热病毒引起的，是全球重大公共卫生问题。近年来它的复苏，特别是在低收入和中等收入国家，导致发病率和死亡率上升。非典型表现,涉及心脏，肝脏,gut,gut肾,血,骨头,紧张,和呼吸系统，在登革热中，会使诊断和管理复杂化。本研究旨在探讨登革热感染者肺部表现的发生率及其与患者预后的相关性。背景在过去的二十年中,登革热的患病率急剧上升,亚洲首当其冲，尤其是印度。登革热肺部并发症的病理生理学尚不清楚，但被认为与毛细血管渗漏综合征和血小板减少症有关。研究表明，呼吸道症状可能与严重病例和死亡率增加有关。尽管印度的研究有限，了解登革热的肺部表现对于提高诊断准确性和患者护理至关重要。方法在K.S.Hegde医院进行回顾性研究。位于芒格洛尔的三级护理机构，印度,涉及2019年1月至12月诊断为登革热的18岁及以上患者。收集的数据包括患者人口统计，临床症状,实验室发现,成像结果，包括射线照片，胸部计算机断层扫描（CT）扫描（如果可访问），胸部和腹部的超声检查，和二维超声心动图，以及患者的结果。通过临床评估确定肺部表现的诊断，胸部X光解释，还有胸部的超声波.使用SPSSStatistics(第20版)进行统计分析，显著性设置为p<0.05。结果在255例登革热病例中，10.19%(n=26)出现肺部表现,以胸腔积液最为常见.年龄较大（>50岁）和合并症与肺部受累的发生率较高相关。呼吸道症状,比如呼吸困难，在肺部并发症患者中更为普遍。实验室参数表明有肺部表现的患者有不同的特征，包括增加的总计数，尿素,胆红素,和肝酶，血小板计数减少.肺部受累患者的死亡率更高，年龄较大,和合并症。讨论研究结果强调了识别登革热中呼吸道症状的重要性，尤其是老年患者和有潜在健康状况的患者。肺部受累与不良后果之间的关联强调了早期发现和适当管理策略的必要性。未来的研究应侧重于阐明登革热肺部并发症的病理生理学，并制定有针对性的干预措施以改善患者的预后。结论登革热的肺部表现是一个重要的临床挑战，并与发病率和死亡率增加有关。早期识别呼吸道症状，随着及时的诊断评估和适当的管理，对改善患者预后至关重要。有必要进行进一步的研究，以加深我们对登革热肺部受累的理解，并优化治疗方法以减轻其对患者预后的影响。
