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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.
Received July 17, 2004. Accepted for publication August 30, 2004.
Acknowledgments: We thank the staff of the Infection Control Team at Chang Gung Memorial Hospital-Kaohsiung Medical Center for their assistance in collection of data for this study.
Authors’ addresses: Ing-Kit Lee and Jien-Wei Liu, Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan, Republic of China. Fax: 866-7-73220402, E-mail: 88b0{at}adm.cgmh.org.tw. Kuender D. Yang, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung, Taiwan, Republic of China.
Reprint requents: Dr. Jien-Wei Liu, Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsuing Hsien, Taiwan 833, Republic of China.
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