Acute Respiratory Failure in Adult Patients with Dengue Virus Infection

Chin-Chou Wang Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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Shih-Feng Liu Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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Shang-Chih Liao Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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Ing-Kit Lee Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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Jien-Wei Liu Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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An-Shen Lin Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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Chao-Chien Wu Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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Yu-Hsiu Chung Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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Meng-Chih Lin Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China; Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, Republic of China

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To investigate clinical course and outcome of dengue with acute respiratory failure (ARF), and to identify related risk factors for acquiring ARF in dengue, we retrospectively studied 11 dengue patients with ARF. From June to December 2002, a total of 606 adult patients were diagnosed as having dengue. Eleven (1.8%) of 606 dengue patients had complications of ARF. The main causes of ARF were sepsis (n = 6, 54.5%) and upper gastrointestinal (UGI) bleeding (n = 3, 27.3%). The mortality rate was 72.7% (n = 8). Additionally, univariate analysis showed that age, dyspnea, cough, prothrombin time, activated partial thromboplastin time, aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine, albumin, renal insufficiency, acute renal failure, acute hepatic failure, UGI bleeding, and combination bacterial infection were significantly predictive variables associated with dengue patients with ARF.

Author Notes

Reprint requests: Meng-Chih Lin, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China and Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, 123 Dabi Road, Niaosung Shiang, Kaohsiung, Taiwan, Republic of China, Telephone: 886-7-731-7123 extension 8199, Fax: 886-7-732-2402, E-mail: mengchih@adm.cgmh.org.tw.
  • 1

    Gubler DJ, 1989. Aedes aegypti and Aedes aegypti-borne disease control in the 1990s: top down or bottom up. Am J Trop Med Hyg 40 :571–578.

  • 2

    Wilder-Smith A, Schwartz E, 2005. Dengue in travelers. N Engl J Med 353 :924–932.

  • 3

    Burke DS, Nisalak A, Johnson DE, Scott RM, 1988. A prospective study of dengue infections in Bangkok. Am J Trop Med Hyg 38 :172–180.

  • 4

    Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N, Viramitrachai W, Ratanachueke S, Kiatpolpoj S, Innis BL, Rothman AL, Nisalak A, Ennus FA, 1997. Early clinical and laboratory indicators of acute dengue illness. J Infect Dis 176 :313–321.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Henchal EA, Putnak JR, 1990. The dengue viruses. Clin Microbiol Rev 3 :376–396.

  • 6

    Balmaseda A, Hammond SN, Perez L, Tellez Y, Saborio SI, Mercado JC, Cuadra R, Rocha J, Perez MA, Silva S, Rocha C, Harris E, 2006. Serotype-specific differences in clinical manifestations of dengue. Am J Trop Med Hyg 74 :449–456.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Gubler DJ, 1998. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev 11 :480–496.

  • 8

    Sharp TW, Wallace MR, Hayes CG, Sanchez JL, DeFraites RF, Arthur RR, Thornton SA, Batchelor RA, Rozmajzl PJ, Hanson RK, 1995. Dengue fever in U.S. troops during Operation Restore Hope, Somalia, 1992–1993. Am J Trop Med Hyg 53 :89–94.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Rigau-Perez JG, Ayala-Lopez A, Garcia-Rivera EJ, Hudson SM, Vorndam V, Reiter P, Cano MP, Clark GG, 2002. The reappearance of dengue-3 and a subsequent dengue-4 and dengue-1 epidemic in Puerto Rico in 1998. Am J Trop Med Hyg 67 :355–362.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Schwartz E, Mendelson E, Sidi Y, 1996. Dengue fever among travelers. Am J Med 101 :516–520.

  • 11

    Gibbons RV, Vaughn DW, 2002. Dengue: an escalating problem. BMJ 324 :1563–1566.

  • 12

    Wu KL, Changchien CS, Kuo CM, Chuah SK, Lu SN, Eng HL, Kuo CH, 2003. Dengue fever with acute acalculous cholecystitis. Am J Trop Med Hyg 68 :657–660.

  • 13

    Lee IK, Liu JW, Yang KD, 2005. Clinical characteristics and risk factors for concurrent bacteremia in adults with dengue hemorrhagic fever. Am J Trop Med Hyg 72 :221–226.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Chiu YC, Wu KL, Kuo CH, Hu TH, Chou YP, Chuah SK, Kuo CM, Kee KM, Changchien CS, Liu JW, Chiu KW, 2005. Endoscopic findings and management of dengue patients with upper gastrointestinal bleeding. Am J Trop Med Hyg 73 :441–444.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Sen MK, Ojha UC, Chakrabarti S, Suri JC, 1999. Dengue hemorrhagic fever (DHF) presenting with ARDS. Indian J Chest Dis Allied Sci 41 :115–119.

  • 16

    Kabra SK, Jain Y, Singhal T, Ratageri VH, 1999. Dengue hemorrhagic fever: clinical manifestations and management. Indian J Pediatr 66 :93–101.

  • 17

    Cam BV, Tuan DT, Fonsmark L, Poulsen A, Tien NM, Tuan HM, Heegaard ED, 2002. Randomized comparison of oxygen mask treatment vs. nasal continuous positive airway pressure in dengue shock syndrome with acute respiratory failure. J Trop Pediatr 48 :335–339.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Porter KR, Beckett CG, Kosasih H, Tan RI, Alisjahbana B, Rudiman PI, Widjaja S, Listiyaningsih E, Ma’Roef CN, McArdle JL, Parwati I, Sudjana P, Jusuf H, Yuwono D, Wuryadi S, 2005. Epidemiology of dengue and dengue hemorrhagic fever in a cohort of adults living in Bandung, West Java, Indonesia. Am J Trop Med Hyg 72 :60–66.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Siqueira JB, Martelli CM, Maciel IJ, Oliveira RM, Ribeiro MG, Amorim FP, Moreira BC, Cardoso DD, Souza WV, Andrade AL, 2004. Household survey of dengue infection in central Brazil: spatial point pattern analysis and risk factors assessment. Am J Trop Med Hyg 71 :646–651.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Nisalak A, Endy TP, Nimmannitya S, Kalayanarooj S, Thisayakorn U, Scott RM, Burke DS, Hoke CH, Innis BL, Vaughn DW, 2003. Serotype-specific dengue virus circulation and dengue disease in Bangkok, Thailand from 1973 to 1999. Am J Trop Med Hyg 68 :191–202.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Azizan A, Sweat J, Espino C, Gemmer J, Stark L, Kazanis D, 2006. Differential proinflammatory and angiogenesis-specific cytokine production in human pulmonary endothelial cells, HPMEC-ST1.6R infected with dengue-2 and dengue-3 virus. J Virol Methods 138 :211–217.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Wiwanitkit V, 2005. Magnitude and pattern of pulmonary pathology in fatal cases of dengue hemorrhagic fever in Thailand. Int J Tuberc Lung Dis 9 :1060.

  • 23

    Setlik RF, Ouellette D, Morgan J, McAllister CK, Dorsey D, Agan BK, Horvath L, Zimmerman MK, Purcell B, 2004. Pulmonary hemorrhage syndrome associated with an autochthonous case of dengue hemorrhagic fever. South Med J 97 :688–691.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Nguyen TH, Nguyen TL, Lei HY, Lin YS, Le BL, Huang KJ, Lin CF, Do QH, Vu TQ, Lam TM, Yeh TM, Huang JH, Liu CC, Halstead SB, 2006. Volume replacement in infants with dengue hemorrhagic fever/dengue shock syndrome. Am J Trop Med Hyg 74 :684–691.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Centers for Disease Control, Republic of China (Taiwan), 2004. Bulletin Statistics of Communicable Diseases and Surveillance Report in Taiwan Area, 2002. Department of Health, The Executive Tuan, Taiwan. Available from http://www.cdc.gov.tw)

    • PubMed
    • Export Citation
  • 26

    Liu JW, Khor BS, Lee CH, Lee IK, Chen RF, Yang KD, 2003. Dengue hemorrhagic fever in Taiwan. Dengue Bull 27 :19–23.

  • 27

    Liu HW, Ho TL, Hwang CS, Liao YH, 1989. Clinical observations of virologically confirmed dengue fever in the 1987 outbreak in southern Taiwan. Kaohsiung J Med Sci 5 :42–49.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    World Health Organization, 1997. Dengue Hemorrhagic Fever: Diagnosis, Treatment, Prevention, and Control. Second edition. Geneva: World Health Organization.

    • PubMed
    • Export Citation
  • 29

    Vincent JL, Sakr Y, Ranieri VM, 2003. Epidemiology and outcome of acute respiratory failure in intensive care unit patients. Crit Care Med 31 :S296–S299.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Lum LC, Thong MK, Cheah YK, Lam SK, 1995. Dengue-associated adult respiratory distress syndrome. Ann Trop Paediatr 15 :335–339.

  • 31

    Diaz A, Kouri G, Guzman MG, Lobaina L, Bravo J, Ruiz A, Ramos A, Martinez R, 1988. Description of the clinical picture of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) in adults. Bull Pan Am Health Organ 22 :133–144.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Isarangkura PB, Pongpanich B, Pintadit P, Phanichyakarn P, Valyasevi A, 1987. Hemostatic derangement in dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health 18 :331–339.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Tsai CJ, Kuo CH, Chen PC, Changcheng CS, 1991. Upper gastrointestinal bleeding in dengue fever. Am J Gastroenterol 86 :33–35.

  • 34

    Ampaiwan C, Vawdaw P, Pimpan T, Chaleomsri TO, Wiwat TO, Pongsakdi K, Teerachai C, 2000. Transfusion requirements in patients with dengue hemorrhagic fever. Southeast Asian J Trop Med Public Health 31 :10–14.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    George R, Liam CK, Chua CT, Lam SK, Pang T, Geethan R, Foo LS, 1988. Unusual clinical manifestations of dengue virus infection. Southeast Asian J Trop Med Public Health 19 :585–590.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Hommel D, Talarmin A, Reynes JM, Hulin A, 1999. Acute renal failure associated with dengue fever in French Guiana. Nephron 83 :183.

  • 37

    Guzman MG, Kouri G, Bravo J, Valdes L, Vazquez S, Halstead SB, 2002. Effect of age on outcome of secondary dengue 2 infections. Int J Infect Dis 6 :118–124.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Garcia-Rivera EJ, Rigau-Perez JG, 2003. Dengue severity in the elderly in Puerto Rico. Rev Panam Salud Publica 13 :362–368.

  • 39

    Resnick NM, 2001. Geriatric medicine. Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, eds. Harrison’s Principle of Internal Medicine. 15th edition. New York: McGraw-Hill, 36–46.

    • PubMed
    • Export Citation
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