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Chest Radiographic Presentation in Patients with Dengue Hemorrhagic Fever

There has been no previously reported case series study regarding chest radiographic (CXR) presentations in dengue hemorrhagic fever (DHF) patients. We retrospectively studied 363 DHF patients from June to December 2002 in southern Taiwan, and a total of 468 CXRs were obtained and reviewed. More than 50% of these showed abnormalities after the 3rd day, with infiltration only and small pleural effusion as the major findings. Progressive changes during the first week and improvements during the second week were observed in these abnormal CXRs. The CXR presentation was also significantly correlated with laboratory findings (white blood cell count, platelet levels, activated partial thromboplastin time, and alanine aminotransferase and albumin levels), as well as the clinical course (renal insufficiency, liver function impairment, upper gastrointestinal bleeding, combination bacterial infection, and duration of admission) and outcome (mortality). The CXR may therefore be a modality for evaluating the clinical course of DHF and should be made during first week after the onset of illness.

Received July 25, 2006. Accepted for publication April 18, 2007.

^* Address correspondence to Meng-Chih Lin, Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Dabi Road, Niaosung Shiang, Kaohsiung, Taiwan. E-mail: mengchih{at}adm.cgmh.org.tw

Authors’ addresses: Chin-Chou Wang, Chao-Chien Wu, An-Shen Lin, Shih-Feng Liu, Yu-Hsiu Chung, Mao-Chang Su, and Meng-Chih Lin, Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Dabi Road, Niaosung Shiang, Kaohsiung, Taiwan. Jien-Wei Liu and Ing-Kit Lee, Division of Infectious Disease, Department of Internal Medicine, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Dabi Road, Niaosung Shiang, Kaohsiung, Taiwan.

Reprint requests: Meng-Chih Lin, Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Dabi Road, Niaosung Shiang, Kaohsi-ung, Taiwan, or Department of Respiratory Care, Chang Gung Institute of Technology, Chia-Yi, Taiwan, 123 Dabi Road, Niaosung Shiang, Kaohsiung, Taiwan, Telephone: +886-7-7317123, ext. 8199, Fax: +886-7-7322402, E-mail: mengchih{at}adm.cgmh.org.tw.