Presenting Complaints in Acute Dengue Infection and Differences in Presenting Complaints Between Primary and Secondary Dengue Infections

Aim and objectives To describe the presenting complaints in acute dengue infection, and identify any differences in presenting complaints between primary and secondary dengue infection patients. Material and methods This cross-sectional observational study was conducted at the Department of Infectious Diseases and Medicine, Holy Family Hospital, Rawalpindi, from July 2019 to December 2019 during the Dengue Rawalpindi Epidemic 2019. Presenting complaints of patients who fulfilled the inclusion criteria of the study were recorded on a proforma on their admissions and their informed consent was taken. Of these patients, 70 primary and 70 secondary dengue infection patients were randomly selected for comparison of presenting complaints. The two groups were compared using the chi-square test and a P-value of <0.05 was considered significant. Results Intermittent fever (88.6%), headache (85%), myalgia (87.9%), arthralgia/bone pain (75%), and retro-orbital pain (47.9%) were common in most dengue patients. Hemorrhagic manifestations, such as rash (15%), epistaxis (11.4%), gum bleeding (15%), melena (7.9%), hematemesis (6.4%), hemoptysis (5.7%), and hematuria (6.4%), were less common. Abdominal pain was significantly more common in secondary dengue infections (50% in secondary dengue infections compared to 32.9% in primary dengue infections). Conclusions Fever, headache, myalgia, arthralgia/bone pains, retro-orbital pain as well as rash, epistaxis, gum bleeding, melena, hematemesis, hemoptysis, hematuria, and decreased urine output despite fluid intake are presenting complaints of dengue infection. Patients with abdominal pain in addition to the above presenting complaints are more likely to be cases of the more serious secondary dengue infection.