Classical dengue hemorrhagic fever resulting from two dengue infections spaced 20 years or more apart:: Havana, Dengue 3 epidemic, 2001-2002

Objective: To report the clinical, laboratory and sonographic findings in 76 adult cases of dengue hemorrhagic fever (DHF). Patients and methods: A dengue 3 epidemic occurred in Havana City from June 2001 to March 2002. 12,889 cases were reported, with 81 DHF cases. From this, 76 serologically confirmed cases were studied descriptively. Results: Bronchial asthma and white race were important risk factors for the severe form of the disease. Fever (100%), headache (92.1%), myalgia (76.3%), arthralgia (73.7%) and retro-orbital pain (57.7%) were the most frequent general symptoms. Vomiting and abdominal pain were observed in 59.2% and 48.6% of cases, respectively. The most common bleeding site was the vagina (64%), followed by the skin (55.2%). Eighteen patients (23.6%) had shock syndrome. Laboratory findings included thrombocytopenia (100%), hemoconcentration (93.4%), an increase in liver enzymes (82.8%), and Leukopenia (71%). Ultrasound detected thickening of the gallbladder wall in 35.1%, pleural effusion in 20.3%, and splenomegaly in 12.9% of cases. Conclusion: These findings contribute to a better understanding of the clinical aspects of DHF in adult patients due to the dengue 3 virus. (c) 2005 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.