title: Clinical characteristics and risk factors for concurrent bacteremia in adults with dengue hemorrhagic fever.
abstract: To better understand the clinical characteristics of concurrent bacteremia (dual infection) in patients with dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) and identify predictive risk factors for dual infection, 100 patients with DHF/DSS (7 with a dual infection and 93 with DHF/DSS alone [controls]) were enrolled in this study. A patient with DHF/DSS who lacked three or more of the five most frequently observed manifestations other than fever in controls or showed disturbed consciousness was defined as one with unusual dengue manifestations. Patients with a dual infection were older, and tended to have prolonged fever, higher frequencies of acute renal failure, gastrointestinal bleeding, altered consciousness, unusual dengue manifestations, and DSS. Acute renal failure (odds ratio [OR] = 51.45, P = 0.002), and prolonged fever (> 5 days) (OR = 26.07, P = 0.017) were independent risk factors for dual infection. Clinicians should be alert to the potential for concurrent bacteremia when treating patients with DHF/DSS who are at risk for dual infection and manage them accordingly.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan, Republic of China.
authors.forename: Ing-Kit
authors.initials: IK
authors.lastname: Lee
authors.forename: Jien-Wei
authors.initials: JW
authors.lastname: Liu
authors.forename: Kuender D
authors.initials: KD
authors.lastname: Yang
mesh_terms: D058186:Acute Kidney Injury; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000150:complications* / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D005334:Fever; D006801:Humans; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019595:Severe Dengue / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology; D013624:Taiwan / Q000453:epidemiology