title: Prospective and descriptive study of adult dengue cases in an emergency department, in Martinique.
abstract: OBJECTIVE
  Knowing about the clinical aspects of dengue in endemic zones is essential to implementation of appropriate case management protocols and public health interventions.
  
  
  METHODS
  The authors made a 4-year prospective, observational study of dengue-infected patients admitted to the emergency department of the Fort-de-France University Hospital.
  
  
  RESULTS
  Two hundred and sixty-three male and 297 female patients were included. The median age was 37 years (range: 14-91). The diagnosis was based on a positive RT-PCR (463 patients) or on the presence of specific IgM (97 patients). Two hundred and seventy-seven patients (49.5%) presented with dengue fever without complications. According to WHO criteria, 95 patients (17%) developed plasma leakage, including 39 patients (7%) diagnosed with DHF, and 10 (1.8%) diagnosed with DSS. Among the other patients without plasma leakage, 84 (15%) had isolated thrombocytopenia, 14 (2.5%) had internal bleeding, and 90 (16%) had unusual manifestations. Seven patients died (1.3%): fulminant hepatitis (two), myocarditis (one), encephalitis (one), acute respiratory failure (one), gangrenous cholecystitis (one), and post-traumatic intracranial hemorrhage (one). The other patients recovered. Seven patients were pregnant (1.3%) from 6 to 27 weeks of amenorrhea and carried their pregnancy to term without complications.
  
  
  CONCLUSIONS
  With this experience, we were able to develop appropriate case management protocols for patients during dengue epidemics.
authors: CIC-EC 802 Inserm, service des urgences, centre d'investigation clinique et d'épidémiologie clinique Antilles-Guyane, centre hospitalier universitaire, 97200 Fort-de-France, Martinique. laurent.thomas@chu-fortdefrance.fr
authors: L
authors: L
authors: Thomas
authors: Y
authors: Y
authors: Brouste
authors: F
authors: F
authors: Najioullah
authors: P
authors: P
authors: Hochedez
authors: Y
authors: Y
authors: Hatchuel
authors: V
authors: V
authors: Moravie
authors: S
authors: S
authors: Kaidomar
authors: J P
authors: JP
authors: King
authors: F
authors: F
authors: Besnier
authors: S
authors: S
authors: Abel
authors: S
authors: S
authors: Carmès
authors: S
authors: S
authors: Schmitt
authors: P
authors: P
authors: Brihier
authors: C
authors: C
authors: Meunier
authors: T
authors: T
authors: Cardoso
authors: J
authors: J
authors: Rosine
authors: P
authors: P
authors: Quenel
authors: R
authors: R
authors: Césaire
authors: A
authors: A
authors: Cabié
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003715:Dengue / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008395:Martinique; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult