title: [Abdominal and gastrointestinal symptoms of Dengue fever. Analysis of a cohort of 8559 patients].
abstract: OBJECTIVE
  Dengue fever is a common disease in tropical and subtropical regions and is characterized by fever, headache, and joint and muscle pain. Occasionally, patients develop abdominal and gastrointestinal symptoms but information about the real frequency of these manifestations is lacking. The aim of this study was to determine the frequency of abdominal and gastrointestinal symptoms in a cohort of patients with Dengue fever.
  
  
  METHODS
  We performed a retrospective review of 8559 patients with a diagnosis of Dengue fever during the 2006 epidemic to determine the frequency of abdominal and gastrointestinal symptoms.
  
  
  RESULTS
  Abdominal and gastrointestinal symptoms were present in 67% of patients. The most frequent symptom was nausea (n=4453, 52%), followed by abdominal pain (n=3058, 36%), vomiting (n=2477, 29%), diarrhea (n=1471, 17%), hepatomegaly, (n=144, 2%), gastrointestinal bleeding (n=34, 0.3%) and ascites (n=8, 0.1%). Hospitalization was required in 1640 patients (19%), of which 1210 (74%, p=0.0001) had some abdominal and gastrointestinal symptoms. In this group, the most frequent symptoms were nausea (n=972, 59%), abdominal pain (n=692, 42%), vomiting (n=668, 41%) and diarrhea (n=393, 24%). Among patients admitted to our hospital for Dengue, 70% showed alterations in liver function tests.
  
  
  CONCLUSIONS
  Our findings suggest that close to 67% of patients with Dengue fever have abdominal and gastrointestinal symptoms or abnormalities in liver function tests. Abdominal and gastrointestinal symptoms were significantly more frequent in patients who were hospitalized. The differential diagnosis of an acute febrile syndrome with abdominal pain or gastrointestinal symptoms in patients living in endemic areas or who have recently travelled to certain regions should include Dengue fever.
authors.affiliation: Departamento de Investigación, Hospital Regional de Alta Especialidad de Veracruz, Veracruz, México. ramos.antonio@inbox.com
authors.forename: Antonio
authors.initials: A
authors.lastname: Ramos-De La Medina
authors.forename: José M
authors.initials: JM
authors.lastname: Remes-Troche
authors.forename: María Fernanda
authors.initials: MF
authors.lastname: González-Medina
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: Anitúa-Valdovinos
authors.forename: Tadeo
authors.initials: T
authors.lastname: Cerón
authors.forename: Claudio
authors.initials: C
authors.lastname: Zamudio
authors.forename: Aurora
authors.initials: A
authors.lastname: Díaz-Vega
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003715:Dengue / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D004196:Disease Outbreaks; D019353:Endemic Diseases; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006984:Hypertrophy / Q000209:etiology; D007223:Infant; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010195:Pancreatitis / Q000209:etiology; D012189:Retrospective Studies; D014195:Travel; D055815:Young Adult