Mucocutaneous Manifestations of Dengue Fever and Its Correlation with Disease Severity: A Cross-Sectional Study
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Introduction
Dengue fever (DF), a mosquito-borne viral illness, has seen a rise in cases worldwide including Nepal. While systemic manifestations are well-documented, mucocutaneous lesions are less studied. This study aims to identify the mucocutaneous manifestations of DF and explore their correlation with disease severity, marking the first such effort in Nepal.
Methods
This hospital-based descriptive cross-sectional study was conducted between August 2023 to July 2024 at Nepal Medical College Teaching Hospital, a tertiary care center in Kathmandu, Nepal. Ethical approval was obtained from the Institutional Review Committee of Nepal Medical College (IRC Reg. No-11-080/81). Non-probability convenient sampling was used. A total of 151 patients clinically diagnosed with DF and confirmed by NS1 antigen and/or IgM positive tests were included. Data were collected using a structured proforma. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 16.
Results
Out of 160,795 patients who visited our hospital from August 2023 to July 2024, 2,059 underwent testing for DF, of which 340 were seropositive, yielding a prevalence of 16.51% (95% CI: 14.97– 18.18) among suspected cases. Among the 151 participants with DF, 93(61.59%) had mucocutaneous involvement, 42 (27.81%) with cutaneous lesions only and 10(6.62%) with mucosal involvement only. Both mucosal and cutaneous manifestations were identified in 41(27.15%). The most common rash was maculopapular 55(36.42%). Pruritus was reported by 65(43.04%) of patients. It was significantly correlated with mucocutaneous involvement (p<0.05). Disease severity classification showed 87 (57.62%) had dengue without warning signs, 52 (34.44%) with warning signs, and 12(7.95%) with severe dengue. Mucocutaneous manifestations was not significantly associated with disease severity in this study.
Conclusion
Mucocutaneous manifestations, including maculopapular rashes and pruritus, are common in DF but they do not necessarily correlate with disease severity. Identifying these signs early can improve diagnosis and management.
