Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 75670

AbstractCase ReportDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Case report
Year : 2022 | Month : June | Volume : 16 | Issue : 6 | Page : OD01 - OD03 Full Version

Serositis as a Presenting Feature of Dengue Fever in a Young Female: Forecast of Upcoming Dengue Shock Syndrome


Published: June 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/51965.16421
Ruchita Kabra, Dhruv Talwar, Sunil Kumar, Sourya Acharya, Praraj Jaiswal

1. Junior Resident, Department of Medicine, Jawaharlal Nehru Medical College and Datta Meghe Institute of Medical Science (Deemed to be University), Sawangi Meghe, Wardha, Maharashtra, India. 2. Junior Resident, Department of Medicine, Jawaharlal Nehru Medical College and Datta Meghe Institute of Medical Science (Deemed to be University), Sawangi Meghe, Wardha, Maharashtra, India. 3. Professor, Department of Medicine, Jawaharlal Nehru Medical College and Datta Meghe Institute of Medical Science (Deemed to be University), Sawangi Meghe, Wardha, Maharashtra, India. 4. Professor and Head, Department of Medicine, Jawaharlal Nehru Medical College and Datta Meghe Institute of Medical Science (Deemed to be University), Sawangi Meghe, Wardha, Maharashtra, India. 5. Junior Resident, Department of Medicine, Jawaharlal Nehru Medical College and Datta Meghe Institute of Medical Science (Deemed to be University), Sawangi Meghe, Wardha, Maharashtra, India.

Correspondence Address :
Dr. Dhruv Talwar,
Junior Resident, Department of Medicine, JNMC, Sawangi, Meghe, Wardha, Maharashtra, India.
E-mail: dhruv.talwar2395@gmail.com

Abstract

Dengue fever is a prominent challenge in the developing countries throughout the world, with dengue shock syndrome as a leading cause of morbidity and mortality during the seasonal dengue epidemics. Most common presenting features of dengue fever are high grade fever with chills, headache, rash, nausea and vomiting. With the increasing challenges of treating dengue shock syndrome to prevent mortality in the young, it is important to determine factors which can be used to predict dengue shock syndrome. This report showcases a case of 20-year-old young female who presented with the chief complaint of pedal oedema, pain in abdomen along with breathlessness. Upon investigations it was found to be dengue fever with pleural effusion and ascites. The patient later developed dengue shock syndrome, which was managed successfully with the help of intravenous fluids, inotropic support and platelet transfusion. Hence, this case report highlights the importance of detection of serositis in the form of ascites, pleural effusion and pedal oedema in dengue fever as a tell-tale sign of upcoming dengue shock syndrome and the pathophysiology behind it.

Keywords

Ascites, Pedal oedema, Pleural effusion

Case Report

A 20-year-old female presented to the Outpatient Department (OPD) with the chief complaint of swelling of both lower limbs, pain in abdomen along with breathlessness for two days. There was history of fever for one day (high grade along with chills). There was no history of nausea, vomiting, retro-orbital pain, headache or rash. Patient had no prior co-morbidities like hypertension, diabetes mellitus, tuberculosis or bronchial asthma.

On examination, pulse was 78 beats per minute, regular in rhythm with normal volume and no special character, blood pressure was 120/70 mmHg in right arm supine position, bilateral pedal oedema was present (Table/Fig 1), there was no pallor, icterus, cyanosis or lymphadenopathy. On systemic examination, there was dull note present on percussion in bilateral infrascapular region with diminished air entry in bilateral infrascapular region. Abdomen was soft and tenderness was present in epigastrium, fluid thrill and shifting dullness was present. Heart sounds were normal and patient was conscious and oriented. Patient was admitted in intensive care unit and investigations were carried out.

As patient gave history of fever associated with chills, differential diagnosis of malaria, dengue, scrub typhus, urinary tract infection and acute appendicitis was made and tested accordingly.

On investigating, patient was found to be dengue non structural protein one positive, IgM positive status and other laboratory investigations are mentioned in (Table/Fig 2). Chest radiograph showed bilateral pleural effusion (Table/Fig 3). Ultrasonography of abdomen showed ascites (Table/Fig 4). Diagnostic pleural tapping was done and fluid was sent for investigations which revealed exudative aetiology. The provisional diagnosis of dengue with serositis was made.

As patient was diagnosed with dengue fever, she was managed with platelet transfusion, intravenous fluids and antibiotics. On day two of admission, her blood pressure was 70/50 mmHg, and she was given intravenous fluids followed by inotropic support and started with injection noradrenaline infusion as per requirement and Blood Pressure (BP) was monitored. The final diagnosis was dengue shock syndrome with serositis. She improved clinically during the course of hospital stay and her inotropic support was tapered accordingly, and stopped on day four of admission.

Her platelet count was monitored regularly and started increasing (39,000/dL on admission to 1,23,000/dL on day six). Her pleural effusion, pedal oedema and ascites resolved completely by day 14 of admission and she was discharged in stable condition.

Discussion

Dengue fever is one of the most common arthropod borne illness of viral origin in developing countries like India. It is transmitted by mosquito vector of the genus Aedes. Dengue has emerged as a leading problem for healthcare facilities in the recent years with periodic epidemics in the tropical, subtropical and temperate areas. Spectrum of dengue fever can range from benign looking innocent fever to life threatening dengue shock syndrome (1). A small number of patients who have history of being infected with dengue fever earlier in life with one of the four serotypes of dengue virus (DENV 1,2,3 or 4) have risk of developing endothelial leak on being infected with another serotype (2). This condition is known as severe dengue or dengue shock syndrome or dengue haemorrhagic fever.

Dengue fever is usually a disease which is self-limiting with a mortality rate of less than one percent when it is diagnosed early and the patient has proper access to healthcare facilities (1). Severe dengue on the other hand has a mortality rate of two to five percent but when it is left untreated the mortality may rise to an alarming 20%. Classically, dengue presents with symptoms such as fever, headache, pain in the retro-orbital area, severe myalgia, arthralgia especially of the knee and the shoulder joint, nausea, vomiting, maculopapular or macular rash predominantly over the face, thorax and flexor surfaces with islands present of skin sparing. In severe dengue, however, signs of endothelial leakage can be seen such as bleeding from sites of minor trauma, signs of gastrointestinal bleed as well as haematuria (3).

Patients may also present with severe pain in abdomen, persistent vomiting which may be accompanied with haematemesis, bleeding from sites of trauma, gastrointestinal bleeding and haematuria (4),(5),(6),(7). Presenting symptoms of severe dengue may also include severe pain in abdomen, persistent vomiting and haematemesis (8). The next 24 hours after these signs of development of endothelial leakage are seen are crucial and if left untreated the patient may develop shock and present with tachypnoea, tachycardia, pallor, dizziness and decreased level of consciousness (9). It is therefore important to predict the development of dengue shock syndrome to prevent mortality and morbidity associated with dengue fever.

Dengue shock syndrome is usually indicated by persistent pain abdomen, vomiting and restlessness (10). Patient presents usually with features suggestive of circulatory collapse such as pallor, tachypnea and tachycardia. Most critical feature of dengue fever remains leakage of plasma. This leakage of plasma is caused by increased endothelial permeability of capillary. This may present as ascites, pleural effusion, pedal oedema and haemoconcentration (11).

In this patient, breathlessness in dengue fever can be due to pleural effusion, acute respiratory distress syndrome, pneumonia and also shock. This differential diagnosis was ruled out by the means of physical examination showing dull node on percussion with diminished air entry which was confirmed by presence of pleural effusion on chest X-ray. Arterial blood gas was also normal with no evidence of acidosis or acute respiratory distress. In a study, conducted in Pakistan, it was established that pleural effusion in cases of dengue fever is usually exudative and is self-resolving (12). A similar approach was followed in this case and the pleural fluid study was suggestive of exudative aetiology which resolved without the need of therapeutic thoracentesis. As this patient had pain in abdomen, ultrasonography of the abdomen was done which revealed ascites. A differential diagnosis for this patient was pancreatic ascites, dengue ascites, renal ascites and cardiac ascites. Pancreatic ascites was ruled out by normal serum amylase and serum lipase levels whereas renal ascites was ruled out by normal serum creatinine and urea levels with a normal renal echotexture on ultrasonography. Cardiac causes of ascites were ruled out through a normal electrocardiography with a normal echocardiography. This leads to the diagnosis of dengue leading to ascites with a positive nonstructural antigen test. Development of this acute ascites in a case of dengue fever is usually considered as an ominous sign and more commonly seems to be associated with severe dengue fever. It also denoted more chances of mortality in dengue fever. Pedal oedema in this case was another sign indicative of plasma leakage.

In a study conducted by Jisamerin J et al., it was found that patients with severe dengue developed serositis and a total of 15.3% patients with dengue had polyserositis, while a total of 31% of patients with severe dengue had serositis with a significant difference observed between severe dengue and dengue with or without warning signs (13). This was also seen in the present case where serosisits was linked with dengue shock syndrome.

Atypical presentations of dengue fever have been reported before however, we report a case of serositis as a sign of impending dengue shock syndrome which shall be essential for the clinicians to detect dengue shock syndrome at the earliest (14),(15),(16).

Conclusion

In the above scenario, it can be postulated that serositis in the patient was due to dengue fever leading to increase in endothelial permeability and plasma leakage. Serositis is a predictor of impending dengue shock syndrome and was treated successfully with fluid replacement therapy judiciously. As the dengue shock syndrome was treated, serositis resolved itself and disappeared on its own. This emphasises that serositis in dengue fever does not need any specific treatment, however, a patient presenting with serositis needs special attention as serositis might be a warning of upcoming deterioration in the form of dengue shock syndrome. It can be concluded that serositis may be an atypical presentation of dengue fever which should not be ignored. Detection of serositis in the form of pleural effusion, ascites or pedal oedema can be a tell-tale sign used to predict dengue shock syndrome in an otherwise benign looking dengue fever.

References

1.
Kalayanarooj S. Clinical manifestations and management of dengue/DHF/DSS. Trop Med Health. 2011;39(4):83-87. [crossref] [PubMed]
2.
Joob B, Wiwanitkit V. Acute ascites as a clinical manifestation of dengue: A case report. J Acute Dis. 2020;9:270-71.
3.
Suwarto S, Nainggolan L, Sinto R, Effendi B, Ibrahim E, Suryamin M, et al. Dengue score: A proposed diagnostic predictor for pleural effusion and/or ascites in adults with dengue infection. BMC Infect Dis. 2016;16:322. [crossref] [PubMed]
4.
Kumar M, Karthikeyan A, Karthikeyan VS. Dengue shock syndrome after percutaneous nephrolithotomy leading to hematuria and renal failure: A rare complication. Indian J Urol. 2020;36(2):136-37. Doi: 10.4103/iju.IJU_335_19. [crossref] [PubMed]
5.
Zhang H, Zhou YP, Peng HJ, Zhang XH, Zhou FY, Liu ZH, et al. Predictive symptoms and signs of severe dengue disease for patients with dengue fever: A meta-analysis. Biomed Res Int. 2014;2014:359308. Doi: 10.1155/2014/359308. [crossref] [PubMed]
6.
Eswarappa M, Reddy SB, John MM, Suryadevara S, Madhyashatha RP. Renal manifestations of dengue viral infection. Saudi J Kidney Dis Transpl. 2019;30(2):394-400. Doi: 10.4103/1319-2442.256847. [crossref] [PubMed]
7.
Raza MA, Khan MA, Ejaz K, Haider MA, Rasheed F. A case of dengue fever with hemorrhagic manifestations. Cureus. 2020;12(6):e8581. Published 2020 Jun 12. Doi: 10.7759/cureus.8581. [crossref]
8.
Navarrete-Espinosa J, Gómez-Dantés H, Celis-Quintal JG, Vázquez-Martínez JL. Clinical profile of dengue hemorrhagic fever cases in Mexico. Salud Publica Mex. 2005;47(3):193-200. Doi: 10.1590/s0036-36342005000300002. [crossref]
9.
Aguilar-Briseño JA, Moser J, Rodenhuis-Zybert IA. Understanding immunopathology of severe dengue: Lessons learnt from sepsis. Curr Opin Virol. 2020;43:41-49. Doi: 10.1016/j.coviro.2020.07.010. [crossref] [PubMed]
10.
Deshwal R, Qureshi MI, Singh R. Clinical and laboratory profile of dengue fever. J Assoc Physicians India. 2015;63(12):30-32.
11.
Wiwanitkit V. Dengue fever: Diagnosis and treatment. Expert Rev Anti Infect Ther 2010;8(7):841-45. [crossref] [PubMed]
12.
Shabbir M, Ameen F, Roshan N, Israr M. Nature and clinical course of pleural effusion in dengue fever. Int J Intern Emerg Med. 2018;1(1):1006.
13.
Jisamerin J, Mohamedkalifa A, Gaur A. Dengue: A neglected disease of concern. Cureus. 2021;13(10):e18500. Doi: 10.7759/cureus.18500. [crossref] [PubMed]
14.
Kumar S, Papalkar P, Sarode R, Acharya S. Cardiac manifestations in dengue. Ind J Med Spec. 2019;10(1):30. [crossref]
15.
Madaan S, Talwar D, Kumar S, Jaiswal A, Acharya N, Eleti MR. Dengue shock syndrome complicating high risk twin pregnancy during late gestation: Extinguishing fuel added flames. Journal of Pharmaceutical Research International. 2021;33(43B):315-19. [crossref]
16.
Mahajan S, Annadatha A, Talwar D, Sesha Satya Sagar VV, Varma AR. Snake bite and dengue: A twin tragedy. Cureus. 2021;13(10):e19097. Published 2021 Oct 28. Doi: 10.7759/cureus.19097. [crossref]

DOI and Others

DOI: 10.7860/JCDR/2022/51965.16421

Date of Submission: Aug 17, 2021
Date of Peer Review: Nov 24, 2021
Date of Acceptance: Dec 23, 2021
Date of Publishing: Jun 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 19, 2021
• Manual Googling: Dec 22, 2021
• iThenticate Software: Jan 03, 2022 (3%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com