A Study of Clinical Profile of Patients presenting with Complications of Acute Febrile Illnesses During Monsoon.

Background: The objective of this study was to describe clinico-laboratory profile and outcome of complicated acute febrile illnesses among inpatients in a tertiary care hospital during monsoon.

Methods: This was an observational, prospective study conducted in a tertiary care hospital in Mumbai, India. Between July 2016 to October 2016, adult patients admitted to the hospital with complicated acute febrile illness were included. Demographic, clinical and laboratory data were collected and analyzed for each patient. Associations were sought between death and organ specific complications.

Results: Out of 276 patients enrolled male gender 187(67.8%) and age group of below 35 years comprised the larger proportion of the cases with total 115(63.2%) dengue,37(80.4%) leptospirosis, 25(69.4%) malaria cases. The most common symptoms reported amongst the enrolled patients included generalized body ache (85.9%), headache (77.4%), vomiting (73.4%), abdominal pain (50%), high coloured urine (34.2%), and breathlessness (32.1%), loose motion (25.1%) and altered Sensorium (8.8%). Clinical signs seen and significantly associated were pedal edema 14.5% (P=0.001), icterus 20.7%(P=0.0001) and tachypnoea 19.4%(P =0.001). Most common complication of dengue was shock (70.9%) followed by hepatic (66.5%) and haematological (65%) derangements, that of malaria was CNS involvement (29.4%), and for leptospirosis it was renal failure (45.9%) followed by respiratory distress (22.3%). Overall mortality in Dengue was 7(3.8%), malaria 2(5.6%), leptospirosis 15(32.6%), Hepatitis E 2(50%).

Conclusion: The similarity in clinical presentation and diversity of etiological agents demonstrates the complexity of diagnosis and treatment of acute febrile illness. This study of clinico-laboratory profile of complicated febrile monsoon illnesses will be helpful to reduce mortality associated with monsoon illnesses by early referral and prompt treatment. Dengue and leptospirosis remain the commonest etiologies and major killer due to respiratory and renal involvements.