Sonographic findings in grade III dengue hemorrhagic fever in adults

Purpose. Sonography has been used to evaluate children with dengue hemorrha gic fever, but to our knowledge no such studies have been conducted with ad ults. We present the sonographic Findings in 40 adults with severe (grade i ll) dengue hemorrhagic fever (DHF). Methods. Forty patients (30 men and 10 women, aged 16-65 years) given a pre sumptive diagnosis of grade III dengue hemorrhagic fever during a documente d regional epidemic underwent abdominal sonography. Ten also underwent ches t radiography. Serologic confirmation was obtained in 5 patients, and in th e rest the diagnosis was based on epidemiologic and clinical findings. Results. Sonographic findings included pleural ef fusion in 21 patients (53 %), thickening of the gallbladder wall in 17 (43%), and mild ascites in 6 ( 15%). These findings were similar to those of previous studies of severe DH F in children,although the incidence of pleural effusion and ascites was sl ightly lower in our series. Neither pleural effusion nor ascites was appare nt on clinical examination; Of the 10 patients who underwent both sonograph y and chest radiography, sonography defected pleural effusion in all 10, wh ereas radiography detected it in only 3. Conclusions. Sonographic findings in DHF in adults (pleural effusions, asci tes, and gallbladder wall thickening) were similar to those described for c hildren but seem to be of lesser severity. Abdominal sonography is a useful diagnostic tool for confirming suspected cases of DHF. Sonography was foun d to be superior to chest radiography in detecting pleural effusions in the 10 patients in whom radiographs were available. (C) 2000 John Wiley & Sons , Inc.