ACUTE MUCOSAL LESIONS OF UPPER DIGESTIVE TRACT IN DENGUE FEVER

CW Hsueh, SC Wen, YY Tsai, CJ Chen, RJ Ben, NS Feng

Department of Medicine, Armed Forces Kaohsiung General Hospital, Kaohsiung, Taiwan, ROC

Dengue virus infection can result in widespread injury of multiple organs included gastrointestional (GI) tract. The purpose of the study is to investigate the clinical features and mucosal injury of upper digestive tract in dengue fever.
METHODS: A total of 96 cases were admitted for dengue fever from June to October 2002. The symptoms of GI tract found during hospitalization were recorded. Patients with GI symptoms or upper GI hemorrhage underwent upper GI endoscopy.
RESULTS: Thirty-five (36.5%) cases had GI symptoms during hospitalization, including abdominal pain in 12 (34.3%), diarrhea in 6 (17.1%), nausea & vomiting in 3 (8.6%) and upper GI bleeding (hematemesis/melena) in 14 (40%) cases. Upper GI endoscopy were performed in 35 cases, 33 (94.3%) of them had acute mucosal lesions, including hemorrhagic gastritis in 24, gastric erosion in 7, esophageal ulcer in 2, gastric ulcer in 13, duodenal ulcer in 9 cases. Eighteen (54.5 %) of 33 cases had two or more mucosal lesions. In patients with upper GI hemorrhage, the blood platelet counts was significant lower than patients without it (8.6±4.3´10⁴/cumm vs 29.1±8.5´10⁴/cumm, p?0.005). Most patients recovered completely.
CONCLUSIONS: Various degrees of acute mucosal lesions in upper digestive tract may present in our patients with dengue fever. Reduction of thrombocyte was a predisposing factor for upper GI hemorrhage.