Volume 73, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


To demonstrate the differences of clinical features and hematologic abnormalities between dengue fever (DF) and dengue hemorrhagic fever (DHF), 359 pediatric patients admitted St. Luke’s Medical Center in Quezon City, between 1999 and 2001 in Metro Manila, and adjoining provinces the Philippines, with a laboratory-confirmed dengue virus infection were evaluated. One third of the patients had DHF, and most of these patients were without shock. Restlessness, epistaxis, and abdominal pain were more associated with DHF. The platelet count was significantly lower in the DHF group than in the DF group before and after defervescence. In the DHF patients, the hematocrit was significantly increased before defervescence, and decreased the day after due to administration of intravenous fluid. Coagulation abnormalities associated with most DHF patients were thrombocytopenia and an increased fibrinolysis, but not disseminated intravascular coagulation. We present recent data on readily obtained clinical and laboratory data that can be used for early diagnosis and consequently earlier appropriate treatment of dengue virus infections.


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  1. Igarashi A, 1997. Impact of dengue virus infection and its control. FEMS Immunol Med Microbiol 18 : 291–300. [Google Scholar]
  2. Guzman MG, Kouri G, 2002. Dengue: an update. Lancet Infect Dis 2 : 33–42. [Google Scholar]
  3. Hammon WM, Rudnick A, Sather GE, 1960. Viruses associated with epidemic hemorrhagic fevers of the Philippines and Thailand. Science 131 : 1102–1103. [Google Scholar]
  4. Venzon EI, Rudnick A, Marchette NJ, Fabie AE, Dukellis E, 1972. The greater Manila dengue hemorrhagic fever epidemic of 1966. J Philippine Med Assoc 48 : 297–313. [Google Scholar]
  5. Dizon JJ, 1978. The occurrence of dengue haemorrhagic fever in the Philippines. Asian J Infect Dis 2 : 15–17. [Google Scholar]
  6. Hayes CG, Corazon RM, Gonzales A, Ranoa CP, 1988. Dengue infections in the Philippines: clinical and virological findings in 517 hospitalized patients. Am J Trop Med Hyg. 39 : 110–116. [Google Scholar]
  7. Songco RS, Hayes CG, Leus CD, Manaloto COR, 1987. Dengue fever/dengue haemorrhagic fever in Filipino children: clinical experience during the 1983–1984 epidemic. Southeast Asian J Trop Med Public Health 18 : 284–290. [Google Scholar]
  8. Nimmannitya S, 1987. Clinical spectrum and management of dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health 18 : 329–397. [Google Scholar]
  9. Kalayanarooj S, Vaughn DW, Nimmannitya S, Gree S, Suntayakorn S, Kunentrasai N, Viramitrachai W, Ratanachueke S, Kiatpolpoj S, Innis BL, Rothman AL, Bisalak A, Ennis FA, 1997. Early clinical and laboratory indicator of acute dengue illness. J Infect Dis 176 : 313–321. [Google Scholar]
  10. Kabra SK, Jain Y, Pandey RM, Madhulika, Sinhai T, Tripathi P, Brooe S, Seth P, Seth V, 1999. Dengue haemorrhagic fever in children in the 1996 Delhi epidemic. Trans R Soc Trop Med Hyg. 93 : 294–298. [Google Scholar]
  11. Vaughn DW, Green S, Kalayanarooj S, Innis BL, Nimmannitya S, Suntayakorn S, Rothman AL, Ennis FA, Nisalak A, 1997. Dengue in the early febrile phase: viremia and antibody responses. J Infect Dis 176 : 322–330. [Google Scholar]
  12. Bundo K, Igarashi A, 1985. Antibody-captured ELISA for detection of immunoglobulin M antibodies in sera from Japanese encephalitis and dengue hemorrhagic fever patients. J Virol Methods 11 : 15–22. [Google Scholar]
  13. Morita K, Tanaka M, Igarashi A, 1991. Rapid identification of dengue virus serotypes by using polymerase chain reaction. J Clin Microbiol 29 : 2107–2110. [Google Scholar]
  14. Rigau-Perez JG, Clark GG, Gubler DJ, Reiter P, Sanders EJ, Vorndam AV, 1998. Dengue and dengue haemorrhagic fever. Lancet. 352 : 971–977. [Google Scholar]
  15. Baalmaseda A, Sandoval E, Perez L, Gutierrez CM, Harris E, 1999. Application of molecular typing techniques in the 1998 dengue epidemic in Nicaragua. Am J Trop Med Hyg. 61 : 893–897. [Google Scholar]
  16. Raengsakulrach B, Nisalak A, Maneekarn N, Yenchitsomanus P, Limsomwong C, Jairungsri A, Thirawuth V, Green S, Kalayanarooj S, Suntayakorn S, Sittisombut N, Malasit P, Vaughn DW, 2002. Comparisons of four reverse transcription-polymerase chain reaction procedures for the detection of dengue virus in clinical specimens. J Virol Methods. 105 : 219–231. [Google Scholar]
  17. World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Second edition Geneva: World Health Organization.
  18. Nishiyama T, Matsukawa T, Hanaoka K, 2000. Is protease inhibitor a choice for the treatment of pre- or mild disseminated intravascular coagulation? Crit Care Med 28 : 1419. [Google Scholar]
  19. Ogden CL, Kaczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Jhonson CL, 2002. Centers for Disease Control and Prevention 2000 Growth Charts for the United States: improvements to the 1977 National Center for Health Statistics Version. Pediatrics 109 : 45–60. [Google Scholar]
  20. Setiawan MW, Samsi TK, Wulur H, Sugianto D, Pool TN, 1998. Epigastric pain and sonographic assessment of the pancreas in dengue hemorrhagic fever. J Clin Ultrasound 26 : 257–259. [Google Scholar]
  21. Wang J, Tseng C, Lee C, Cheng K, 1990. Clinical and upper gastroendoscopic features of patients with dengue virus infection. J Gastroenterol Hepatol 5 : 664–668. [Google Scholar]
  22. Boonpucknavig S, Lohachitranond C, Nimmanitya S, 1979. The pattern and nature of the lymphocyte population response in dengue hemorrhagic fever. Am J Trop Med Hyg 28 : 885–889. [Google Scholar]
  23. Suvatte V, Longsaman M, 1979. Diagnostic value of buffy coat preparation in dengue hemorrhagic fever. Southeast Asian J Trop Med Public Health 10 : 7–12. [Google Scholar]
  24. Thisyakorn U, Nimmannitya S, Ninganond V, Soogarun S, 1984. Atypical lymphocytes in dengue hemorrhagic fever: it’s value in diagnosis. Southeast Asian J Trop Med Public Health 15 : 32–36. [Google Scholar]
  25. Mitrakul C, Poshyachinda M, Futralul P, Sangkawibha N, Ahandrik S, 1977. Hemostatic and platelet kinetic studies in dengue hemorrhagic fever. Am J Trop Med Hyg. 26 : 975–984. [Google Scholar]
  26. Srichaikul T, Nimmannitya S, Artchararit N, Sriasawakul T, Sungpeuk P, 1977. Fibrinogen metabolism and disseminated intravascular coagulation in dengue hemorrhagic fever. Am J Trop Med Hyg 26 : 525–532. [Google Scholar]
  27. Huang YH, Liu CC, Wang ST, Lei HY, Liu HS, Lin YS, Wu HL, Yeh TM, 2001. Activation of coagulation and fibrinolysis during dengue virus infection. J Med Virol 63 : 247–251. [Google Scholar]
  28. Wills B, Oraqui EE, Stephens AC, Daramola OA, Dung NM, Loan HT, Chau NV, Chambers M, Stepniewska K, Farrar JJ, Levin M, 2002. Coagulation abnormalities in dengue hemorrhagic fever: serial investigations in 167 Vietnamese children with dengue shock syndrome. Clin Infect Dis 35 : 277–285. [Google Scholar]
  29. Krishnamurti C, Kalayanarooj S, Cutting MA, Peat RA, Rothwell SW, Reid TJ, Green S, Nisalak A, Endy TP, Vaughn DW, Nimmannitya S, Innis BL, 2001. Mechanisms of hemorrhage in dengue without circulatory collapse. Am J Trop Med Hyg 65 : 840–847. [Google Scholar]

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  • Received : 30 May 2004
  • Accepted : 13 Apr 2005

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