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Secondary bacteraemia in adult patients with prolonged dengue fever

Authors:

R Premaratna ,

University of Kelaniya, LK
About R
Department of Medicine, Faculty of Medicine
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D Dissanayake,

University of Kelaniya, LK
About D
University Medical Unit, Faculty of Medicine
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FHDS Silva,

University of Kelaniya, LK
About FHDS
University Medical Unit, Faculty of Medicine
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M Dassanayake,

University of Kelaniya, LK
About M
Department of Microbiology, Faculty of Medicine
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HJ de Silva

University of Kelaniya
About HJ
Department of Medicine, Faculty of Medicine
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Abstract

Introduction Although dengue management guidelines do not advice on use of antibiotics in dengue shock syndrome, unrecognised bactraemia is likely to contribute to morbidity and mortality.

Objectives To assess the occurance of secondary bacteraemia in adult patients with prolonged dengue fever.

Methods A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days). Two sets of blood cultures were taken in such patients prior to institution of antibiotic therapy. Demographic, clinical, haematological and biochemical parameters were recorded. Development of ascites and pleural effusions were detected using ultrasonography.

Results Fourty patients (52.5% males) with a mean age of 29.8 years (SD 13.6) were studied. The average duration of fever was 7.9 days (SD 1.8). Ten patients (25%) had bacterial isolates in their blood cultures; Staphylococcus aureus (n=2), coliforms (n=3), pseudomonas (n=1) and 4 had mixed growths. The culture positive group had severe body aches at admission and higher fever, third space fluid accumulation, a significant drop in platelets and a higher CRP.

Conclusions A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture positive patients appeared more ill with body aches and had higher degrees of fever during the latter part of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia, low platelet count and elevation of CRP seem to be helpful.

Ceylon Medical Journal 2015; 60: 10-12

Keywords: dengue bacteraemia 
DOI: http://doi.org/10.4038/cmj.v60i1.7165
How to Cite: Premaratna, R. et al., (2015). Secondary bacteraemia in adult patients with prolonged dengue fever. Ceylon Medical Journal. 60(1), pp.10–12. DOI: http://doi.org/10.4038/cmj.v60i1.7165
Published on 17 Mar 2015.
Peer Reviewed

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