Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study
Abstract Introduction Dengue viruses cause either symptomatic infections or asymptomatic seroconversion. Symptomatic dengue has a wide clinical spectrum ranging from self-limiting infection to severe manifestations, mostly characterized by plasma leakage with or without hemorrhage. World Health Orga...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12879-025-10486-5 |
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| author | Bibechan Thapa Prakriti Lamichhane Trishna Shrestha Saral Lamichhane Shreyasi Karki Sneha Pradhananga Kabita Hada Batajoo Prajwal Pudasaini |
| author_facet | Bibechan Thapa Prakriti Lamichhane Trishna Shrestha Saral Lamichhane Shreyasi Karki Sneha Pradhananga Kabita Hada Batajoo Prajwal Pudasaini |
| author_sort | Bibechan Thapa |
| collection | DOAJ |
| description | Abstract Introduction Dengue viruses cause either symptomatic infections or asymptomatic seroconversion. Symptomatic dengue has a wide clinical spectrum ranging from self-limiting infection to severe manifestations, mostly characterized by plasma leakage with or without hemorrhage. World Health Organization classification in 2009 classified dengue into dengue without warning signs, dengue with warning signs, and severe dengue. This study aimed to determine patient characteristics and hematological parameters (leukopenia, and thrombocytopenia) in patients with dengue infection in the emergency department of a tertiary center. Methods A cross-sectional study was conducted among 252 patients with dengue confirmed by serological testing against dengue-specific nonstructural protein 1 (NS1) antigen and immunoglobulin M (IgM) by enzyme-linked immunosorbent assay from September to November 2022 who presented in the emergency department of a tertiary hospital in Nepal after ethical approval was obtained. Dengue was categorized according to the World Health Organization 2009 classification. Hematological parameters were recorded by reviewing patients’ laboratory records. Data analysis was done using descriptive statistical parameters and a chi-square test. Results Dengue without warning signs was present in 166 (65.87%) patients, while dengue with warning signs and severe dengue was present in 68 (26.89%) and 18 (7.14%) patients, respectively. Leukopenia (< 4000 cells/mm3) was present among 163 (64.68%) patients. The lowest recorded leukocyte count was 1440. Similarly, thrombocytopenia (< 150000 cells/mm3) was present among 102 patients (40.48%). The lowest recorded platelet count was 26,000 cells/mm3. A significant association was found between the severity of dengue infection and leukopenia (χ2 13.268, p-value 0.001) and thrombocytopenia (χ2 43.924, p value < 0.001). Conclusions Monitoring of warning signs and clinical parameters is important for identifying the progression of dengue infection to the critical phase. Leukopenia and thrombocytopenia are present among many dengue-infected patients presenting in the emergency department. The severity of the disease will usually only be apparent around defervescence, which often coincides with the onset of the critical phase. Leukopenia and thrombocytopenia could indicate progression to severe disease during emergency department admission. |
| format | Article |
| id | doaj-art-557d9546c3a840a4b286e5ad36968f66 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-557d9546c3a840a4b286e5ad36968f662025-01-19T12:11:56ZengBMCBMC Infectious Diseases1471-23342025-01-012511710.1186/s12879-025-10486-5Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional studyBibechan Thapa0Prakriti Lamichhane1Trishna Shrestha2Saral Lamichhane3Shreyasi Karki4Sneha Pradhananga5Kabita Hada Batajoo6Prajwal Pudasaini7Department of Emergency Medicine, Nepal National HospitalDepartment of Emergency Medicine and General Practice, KIST Medical College and Teaching HospitalDepartment of Emergency Medicine and General Practice, KIST Medical College and Teaching HospitalDepartment of Internal Medicine, Gandaki Medical CollegeDepartment of Emergency Medicine and General Practice, KIST Medical College and Teaching HospitalDepartment of Emergency Medicine and General Practice, KIST Medical College and Teaching HospitalDepartment of Emergency Medicine and General Practice, KIST Medical College and Teaching HospitalDepartment of Dermatology, Civil Service HospitalAbstract Introduction Dengue viruses cause either symptomatic infections or asymptomatic seroconversion. Symptomatic dengue has a wide clinical spectrum ranging from self-limiting infection to severe manifestations, mostly characterized by plasma leakage with or without hemorrhage. World Health Organization classification in 2009 classified dengue into dengue without warning signs, dengue with warning signs, and severe dengue. This study aimed to determine patient characteristics and hematological parameters (leukopenia, and thrombocytopenia) in patients with dengue infection in the emergency department of a tertiary center. Methods A cross-sectional study was conducted among 252 patients with dengue confirmed by serological testing against dengue-specific nonstructural protein 1 (NS1) antigen and immunoglobulin M (IgM) by enzyme-linked immunosorbent assay from September to November 2022 who presented in the emergency department of a tertiary hospital in Nepal after ethical approval was obtained. Dengue was categorized according to the World Health Organization 2009 classification. Hematological parameters were recorded by reviewing patients’ laboratory records. Data analysis was done using descriptive statistical parameters and a chi-square test. Results Dengue without warning signs was present in 166 (65.87%) patients, while dengue with warning signs and severe dengue was present in 68 (26.89%) and 18 (7.14%) patients, respectively. Leukopenia (< 4000 cells/mm3) was present among 163 (64.68%) patients. The lowest recorded leukocyte count was 1440. Similarly, thrombocytopenia (< 150000 cells/mm3) was present among 102 patients (40.48%). The lowest recorded platelet count was 26,000 cells/mm3. A significant association was found between the severity of dengue infection and leukopenia (χ2 13.268, p-value 0.001) and thrombocytopenia (χ2 43.924, p value < 0.001). Conclusions Monitoring of warning signs and clinical parameters is important for identifying the progression of dengue infection to the critical phase. Leukopenia and thrombocytopenia are present among many dengue-infected patients presenting in the emergency department. The severity of the disease will usually only be apparent around defervescence, which often coincides with the onset of the critical phase. Leukopenia and thrombocytopenia could indicate progression to severe disease during emergency department admission.https://doi.org/10.1186/s12879-025-10486-5DengueEmergencyLeukopeniaSeverity of dengueThrombocytopenia |
| spellingShingle | Bibechan Thapa Prakriti Lamichhane Trishna Shrestha Saral Lamichhane Shreyasi Karki Sneha Pradhananga Kabita Hada Batajoo Prajwal Pudasaini Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study BMC Infectious Diseases Dengue Emergency Leukopenia Severity of dengue Thrombocytopenia |
| title | Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study |
| title_full | Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study |
| title_fullStr | Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study |
| title_full_unstemmed | Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study |
| title_short | Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study |
| title_sort | leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in nepal a cross sectional study |
| topic | Dengue Emergency Leukopenia Severity of dengue Thrombocytopenia |
| url | https://doi.org/10.1186/s12879-025-10486-5 |
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