Wilder-Smith A , Ooi E-E , Horstick O , Wills B , 2019. Dengue. Lancet 393: 350–363.
Taylor WR et al., 2015. Dengue in adults admitted to a referral hospital in Hanoi, Vietnam. Am J Trop Med Hyg 92: 1141–1149.
de Almeida RR , Paim B , de Oliveira SA , Souza AS , Gomes ACP , Escuissato DL , Zanetti G , Marchiori E , 2017. Dengue hemorrhagic fever: a state-of-the-art review focused in pulmonary involvement. Lung 195: 389–395.
Miranda CH et al., 2013. Evaluation of cardiac involvement during dengue viral infection. Clin Infect Dis 57: 812–819.
Yacoub S , Griffiths A , Hong Chau TT , Simmons CP , Wills B , Hien TT , Henein M , Farrar J , 2012. Cardiac function in Vietnamese patients with different dengue severity grades. Crit Care Med 40: 477–483.
Kirawittaya T , Yoon I , Wichit S , Green S , Ennis FA , Gibbons RV , Thomas SJ , Rothman AL , Kalayanarooj S , Srikiatkhachorn A , 2015. Evaluation of cardiac involvement in children with dengue by serial echocardiographic studies. PLoS Negl Trop Dis 9: e0003943.
Jessie K , Fong MY , Devi S , Lam SK , Wong KT , 2004. Localization of dengue virus in naturally infected human tissues, by immunohistochemistry and in situ hybridization. J Infect Dis 189: 1411–1418.
Póvoa TF , Alves AMB , Oliveira CAB , Nuovo GJ , Chagas VLA , Paes MV , 2014. The pathology of severe dengue in multiple organs of human fatal cases: histopathology, ultrastructure and virus replication. PLoS One 9: e83386.
Wang CC , Wu CC , Liu JW , Lin AS , Liu SF , Chung YH , Su MC , Lee IK , Lin MC , 2007. Chest radiographic presentation in patients with dengue hemorrhagic fever. Am J Trop Med Hyg 77: 291–296.
Rodrigues RS , Brum ALG , Paes MV , Povoa TF , Basilio de Oliveira CA, Marchiori E, Borghi DP, Ramos GV, Bozza FA, 2014. Lung in dengue: computed tomography findings. PLoS One 9: e96313.
Srikiatkhachorn A et al., 2007. Natural history of plasma leakage in dengue hemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J 26: 283–290.
Llamas-Álvarez AM , Tenza-Lozano EM , Latour-Pérez J , 2017. Accuracy of lung ultrasound in the diagnosis of pneumonia in adults: systematic review and meta-analysis. Chest 151: 374–382.
Pereda M , Chavez M , Hooper-Miele C , Gilman R , Steinhoff M , Ellington L , Gross M , Price C , Tielsch J , Checkley W , 2015. Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics 135: 714–722.
Wu HD , Yang PC , Kuo SH , Luh KT , 1989. Ultrasonography in complete chest X-ray opacification of hemithorax. Taiwan Yi Xue Hui Za Zhi 88: 694–699.
Alrajab S , Youssef AM , Akkus NI , Caldito G , 2013. Pleural ultrasonography versus chest radiography for the diagnosis of pneumothorax: review of the literature and meta-analysis. Crit Care 17: R208.
Pivetta E et al., 2015. Lung ultrasound-implemented diagnosis of acute decompensated heart failure in the ED: a SIMEU multicenter study. Chest 148: 202–210.
Gryminski J , Krakówka P , Lypacewicz G , 1976. The diagnosis of pleural effusion by ultrasonic and radiologic techniques. Chest 70: 33–37.
Soni NJ , Franco R , Velez MI , Schnobrich D , Dancel R , Restrepo MI , Mayo PH , 2015. Ultrasound in the diagnosis and management of pleural effusions. J Hosp Med 10: 811–816.
Emamian SA , Kaasbol MA, Olsen JF, Pedersen JF, 1997. Accuracy of the diagnosis of pleural effusion on supine chest X-ray. Eur Radiol 7: 57–60.
Volpicelli G et al., 2012. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38: 577–591.
Thanachartwet V , Wattanathum A , Sahassananda D , Wacharasint P , Chamnanchanunt S , Khine Kyaw E , Jittmittraphap A , Naksomphun M , Surabotsophon M , Desakorn V , 2016. Dynamic measurement of hemodynamic parameters and cardiac preload in adults with dengue: a prospective observational study. PLoS One 11: 1–17.
WHO , 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. 2nd edition. Geneva, Switzerland: World Health Organization. Available at: https://apps.who.int/iris/handle/10665/41988.
WHO , 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention, and Control. Geneva, Switzerland: World Health Organization. Available at: https://apps.who.int/iris/handle/10665/44188.
WHO , 2012. Handbook for Clinical Management of Dengue. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/denguecontrol/9789241504713/en/.
Martindale JL , Noble VE , Liteplo A , 2013. Diagnosing pulmonary edema. Eur J Emerg Med 20: 356–360.
Dietrich CF , Mathis G , Blaivas M , Volpicelli G , Seibel A , Wastl D , Atkinson NSS , Cui XW , Fan M , Yi D , 2016. Lung B-line artefacts and their use. J Thorac Dis 8: 1356–1365.
Lichtenstein D , Mezière G , Seitz J , 2009. The dynamic air bronchogram: a lung ultrasound sign of alveolar consolidation ruling out atelectasis. Chest 135: 1421–1425.
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Lung ultrasound (LUS) is a more sensitive method of detecting pathological pulmonary changes than chest X-ray. Therefore, LUS for patients with dengue could be an important tool for the early detection of pleural effusions and pulmonary edema signifying capillary plasma leakage, which is the hallmark of severe dengue pathophysiology. We conducted a prospective observational study of pulmonary changes identifiable with LUS in dengue patients admitted to the Hospital for Tropical Diseases in Mahidol University, Bangkok, and the Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand. The LUS findings were described according to standard criteria, including the presence of A, B1, B2, and C patterns in eight chest regions and the presence of pleural effusions. From November 2017 to April 2018, 50 patients with dengue were included in the study. LUS was performed during the febrile phase for nine patients (18%) and during the critical-convalescence phase for 41 patients (82%). A total of 33 patients (66%) had at least one abnormality discovered using LUS. Abnormal LUS findings were observed more frequently during the critical-convalescence phase (N = 30/41; 73%) than during the febrile phase (N = 3/9; 33%) (P = 0.047). Abnormal aeration patterns were observed in 31 patients (62%). Only B patterns with only multiple B lines were observed in 21 patients (42%); of these patients, three had already exhibited B patterns during the febrile phase (N = 3). C patterns (N = 10; 24%), pleural effusion (N = 10; 24%), and subpleural abnormalities (N = 11; 27%) were observed only during the critical-convalescence phase. LUS can detect signs of capillary leakage, including interstitial edema and pleural effusions, early during the course of dengue.
Financial support: This work was funded by Faculty of Tropical Medicine, Mahidol University.
Authors’ addresses: Hiroshi Koyama, Department of Critical Care Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan, E-mail: ko1978hiro@gmail.com. Wirongrong Chierakul, Prakaykaew Charunwatthana, Benjaluck Phonrat, and Udomsak Silachamroon, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mails: wirongrong.chi@mahidol.ac.th, prakaykaew.cha@mahidol.ac.th, benjaluck.pho@mahidol.ac.th, and udomsak.sil@mahidol.ac.th. Natpatou Sanguanwongse, Department of Medicine, Bamrasnaradura Infectious Disease Institute, Nonthaburi, Thailand, E-mail: natpatou@yahoo.com. Arjen M. Dondorp, Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: arjen@tropmedres.ac.
Wilder-Smith A , Ooi E-E , Horstick O , Wills B , 2019. Dengue. Lancet 393: 350–363.
Taylor WR et al., 2015. Dengue in adults admitted to a referral hospital in Hanoi, Vietnam. Am J Trop Med Hyg 92: 1141–1149.
de Almeida RR , Paim B , de Oliveira SA , Souza AS , Gomes ACP , Escuissato DL , Zanetti G , Marchiori E , 2017. Dengue hemorrhagic fever: a state-of-the-art review focused in pulmonary involvement. Lung 195: 389–395.
Miranda CH et al., 2013. Evaluation of cardiac involvement during dengue viral infection. Clin Infect Dis 57: 812–819.
Yacoub S , Griffiths A , Hong Chau TT , Simmons CP , Wills B , Hien TT , Henein M , Farrar J , 2012. Cardiac function in Vietnamese patients with different dengue severity grades. Crit Care Med 40: 477–483.
Kirawittaya T , Yoon I , Wichit S , Green S , Ennis FA , Gibbons RV , Thomas SJ , Rothman AL , Kalayanarooj S , Srikiatkhachorn A , 2015. Evaluation of cardiac involvement in children with dengue by serial echocardiographic studies. PLoS Negl Trop Dis 9: e0003943.
Jessie K , Fong MY , Devi S , Lam SK , Wong KT , 2004. Localization of dengue virus in naturally infected human tissues, by immunohistochemistry and in situ hybridization. J Infect Dis 189: 1411–1418.
Póvoa TF , Alves AMB , Oliveira CAB , Nuovo GJ , Chagas VLA , Paes MV , 2014. The pathology of severe dengue in multiple organs of human fatal cases: histopathology, ultrastructure and virus replication. PLoS One 9: e83386.
Wang CC , Wu CC , Liu JW , Lin AS , Liu SF , Chung YH , Su MC , Lee IK , Lin MC , 2007. Chest radiographic presentation in patients with dengue hemorrhagic fever. Am J Trop Med Hyg 77: 291–296.
Rodrigues RS , Brum ALG , Paes MV , Povoa TF , Basilio de Oliveira CA, Marchiori E, Borghi DP, Ramos GV, Bozza FA, 2014. Lung in dengue: computed tomography findings. PLoS One 9: e96313.
Srikiatkhachorn A et al., 2007. Natural history of plasma leakage in dengue hemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J 26: 283–290.
Llamas-Álvarez AM , Tenza-Lozano EM , Latour-Pérez J , 2017. Accuracy of lung ultrasound in the diagnosis of pneumonia in adults: systematic review and meta-analysis. Chest 151: 374–382.
Pereda M , Chavez M , Hooper-Miele C , Gilman R , Steinhoff M , Ellington L , Gross M , Price C , Tielsch J , Checkley W , 2015. Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics 135: 714–722.
Wu HD , Yang PC , Kuo SH , Luh KT , 1989. Ultrasonography in complete chest X-ray opacification of hemithorax. Taiwan Yi Xue Hui Za Zhi 88: 694–699.
Alrajab S , Youssef AM , Akkus NI , Caldito G , 2013. Pleural ultrasonography versus chest radiography for the diagnosis of pneumothorax: review of the literature and meta-analysis. Crit Care 17: R208.
Pivetta E et al., 2015. Lung ultrasound-implemented diagnosis of acute decompensated heart failure in the ED: a SIMEU multicenter study. Chest 148: 202–210.
Gryminski J , Krakówka P , Lypacewicz G , 1976. The diagnosis of pleural effusion by ultrasonic and radiologic techniques. Chest 70: 33–37.
Soni NJ , Franco R , Velez MI , Schnobrich D , Dancel R , Restrepo MI , Mayo PH , 2015. Ultrasound in the diagnosis and management of pleural effusions. J Hosp Med 10: 811–816.
Emamian SA , Kaasbol MA, Olsen JF, Pedersen JF, 1997. Accuracy of the diagnosis of pleural effusion on supine chest X-ray. Eur Radiol 7: 57–60.
Volpicelli G et al., 2012. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38: 577–591.
Thanachartwet V , Wattanathum A , Sahassananda D , Wacharasint P , Chamnanchanunt S , Khine Kyaw E , Jittmittraphap A , Naksomphun M , Surabotsophon M , Desakorn V , 2016. Dynamic measurement of hemodynamic parameters and cardiac preload in adults with dengue: a prospective observational study. PLoS One 11: 1–17.
WHO , 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. 2nd edition. Geneva, Switzerland: World Health Organization. Available at: https://apps.who.int/iris/handle/10665/41988.
WHO , 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention, and Control. Geneva, Switzerland: World Health Organization. Available at: https://apps.who.int/iris/handle/10665/44188.
WHO , 2012. Handbook for Clinical Management of Dengue. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/denguecontrol/9789241504713/en/.
Martindale JL , Noble VE , Liteplo A , 2013. Diagnosing pulmonary edema. Eur J Emerg Med 20: 356–360.
Dietrich CF , Mathis G , Blaivas M , Volpicelli G , Seibel A , Wastl D , Atkinson NSS , Cui XW , Fan M , Yi D , 2016. Lung B-line artefacts and their use. J Thorac Dis 8: 1356–1365.
Lichtenstein D , Mezière G , Seitz J , 2009. The dynamic air bronchogram: a lung ultrasound sign of alveolar consolidation ruling out atelectasis. Chest 135: 1421–1425.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 2761 | 1518 | 75 |
Full Text Views | 254 | 26 | 1 |
PDF Downloads | 232 | 23 | 1 |