Dengue in adults admitted to a referral hospital in Hanoi, Vietnam.
Knowledge of adult dengue virus (DENV) infection from Hanoi, Vietnam, is limited. In 2008, we prospectively studied 143 (77 male) confirmed (nonstructural 1 antigen enzyme-linked immunosorbent assay [ELISA], DENV polymerase chain reaction, paired serology) adult dengue patients of median age 23.5 (range 16-72) years. They were admitted to the National Hospital for Tropical Diseases, Hanoi, on median illness day (D) 5 (range 1-8). By D8, 141 (98.6%) were afebrile. Platelet counts and hematocrit (median, interquartile range [IQR]) nadired and peaked on D5 and D4, respectively: 40,000/μL (10,000-109,000/μL), 43.4% (34.9-49.7%). Four (2.8%) patients had severe dengue: 1) D10 shock (N = 1) and 2) aspartate aminotransferase (AST) ≥ 1,000 IU/L (N = 3, D5 and D7). Of 143 patients, 118 (82.5%) had ≥ 1 warning sign (World Health Organization [WHO] 2009 criteria): mucosal bleeding 66/143 (46.1%), soft tissue edema 54/143 (37.7%), and ultrasound detected plasma leakage (pleural effusions/ascites) 30/129 (23.25%). 138 (96.5%) patients received intravenous (IV) fluids: 3 L (IQR: 0.5-8.5 L). Most patients had non-severe dengue with warning signs. High rates of edema and plasma leakage may be explained partly by liberal use of IV fluids. Studies are needed on optimizing fluid management in non-severe adult dengue.
Walter R
WR
Taylor
Annette
A
Fox
Khuong Thi
KT
Pham
Hoa Nguyen Minh
HNM
Le
Ninh Thi Hai
NTH
Tran
Giang Van
GV
Tran
Binh Thanh
BT
Nguyen
My Van
MV
Nguyen
Lien Thi
LT
Nguyen
Sophie
S
Yacoub
Hoai Thi Thu
HTT
Nguyen
Ha Hong
HH
Nguyen
Hien Duc
HD
Nguyen
Heiman
H
Wertheim
Peter
P
Horby
Jeremy
J
Farrar
Lien Thi Minh
LTM
Trinh
Kinh Van
KV
Nguyen
D000293:Adolescent; D000328:Adult; D000368:Aged; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D003716:Dengue Virus; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult