Vesicular wall thickening and dengue in pediatric patients
Keywords:
dengue, dengue shock syndrome, dengue virus, gallbladder, severe dengueAbstract
Introduction: Dengue is a common arbovirus with a high incidence of complications in children and in which thickening of the vesicular wall is a frequent ultrasound finding.
Objective: To evaluate the correlation between thickening of the vesicular wall and clinical, laboratory and ultrasound findings in patients with dengue.
Methods: A cross-sectional study was carried out in 119 patients admitted with a diagnosis of dengue in the period between January and October 2024. The variables studied are: clinical warning signs upon admission, presence of leukopenia, thrombocytopenia, hemoconcentration or hypertransaminasemia, ultrasound findings, IgM results and development of severe dengue or dengue shock. Statistically, the Phi coefficient is used, chi-square, sensitivity, specificity, positive and negative predictive value and odds ratio are calculated.
Results: Vesicular wall thickening is present in 31.9% of cases and values ≥ 9 mm were strongly associated with hepatomegaly (0.37), hypertransaminasemia (0.26), hemoconcentration (0.19), localized abdominal pain (0.18) and laminar free fluid (0.17). The positive predictive value is 93.5%. The development of severe dengue and positive IgM are 10 and 16 times more frequent in cases with vesicular wall thickening.
Conclusions: Thickening of the gallbladder wall correlates with clinical, laboratory and ultrasound signs that are linked to the liver, in addition to predicting the evolution to severe forms of the disease.
Downloads
References
1. Cruz López CY, Carlos Sánchez M, Terrones Santa Cruz LV, Saldaña Jiménez MY. Conocimientos y medidas preventivas sobre arbovirosis en estudiantes universitarios de una zona endémica del Perú [Internet]. Rev inf cient. 2022 [acceso: 04/11/2024]; 101(4):e3851. Disponible en: http://www.revinfcientifica.sld.cu/index.php/ric/article/view/3851
2. Consuegra Otero A, Martínez Torres E, González Rubio D, Castro Peraza M. Caracterización clínica y de laboratorio en pacientes pediátricos en la etapa crítica del dengue [Internet]. Rev Cubana Pediatría. 2019 [acceso: 04/11/2024]; 91(2):e645. Disponible en: https://revpediatria.sld.cu/index.php/ped/article/view/645
3. Consuegra Otero A, Martínez Torres E, Castro Peraza M. Comportamiento clínico y de laboratorio del choque por dengue en pacientes pediátricos [Internet]. Rev Cuba Med Tropical. 2021 [acceso: 04/11/2024]; 73(1):e489. Disponible en: https://revmedtropical.sld.cu/index.php/medtropical/article/view/489
4. Galindo Estévez M, Brito Portuondo CA, Borroto Martínez K. Dengue: escenario actual [Internet]. Rev Cubana Med Trop. 2023 [acceso: 04/11/2024]; 75(2):e1014. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0375-07602023000200004&lng=es
5. Organización Mundial de la Salud. Dengue situación mundial. 2023. [acceso: 04/11/2024]. Disponible en: https://www.who.int/es/emergencies/disease-outbreak-news/item/2023-DON498
6. Setyawati AN, Tjahjono DK, Chionardes MA, Arkhaesi N. Acute acalculous cholecystitis in a pediatric dengue hemorrhagic fever patient: A case report, lesson learned from limited resource setting [Internet]. Ann Med Surg (Lond). 2022; 81:104437. DOI: 10.1016/j.amsu.2022.104437
7. Nainggolan L, Wiguna C, Hasan I, Dewiasty E. Gallbladder Wall. Thickening for Early Detection of Plasma Leakage in Dengue Infected Adult Patients [Internet]. Acta Med Indones. 2018 [acceso: 04/11/2024]; 50(3):193-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30333268/
8. Consuegra Otero A, Rodríguez Prieto M, Acosta Torres JR. Hallazgos clínicos-ultrasonográficos en pacientes pediátricos con dengue con signos de alarma y dengue grave [Internet]. Rev Cubana Pediatría. 2023 [acceso: 04/11/2024]; 95(2023):e3988. Disponible en: https://revpediatria.sld.cu/index.php/ped/article/view/3988
9. Gurung S, Karki S, Khadka M, Gurung S, Dhakal S. Acute acalculous cholecystitis in a patient with dengue fever: A case report [Internet]. Ann Med Surg (Lond). 2022; 84:104960. DOI: 10.1016/j.amsu.2022.104960
10. Asghar MS, Yasmin F, Tahir MJ, Anwar S, Yaseen R, Yousaf Z. Predictive Analysis of Gallbladder Wall Thickness as a Marker for Bleeding Risk and Need for Transfusion in Dengue Patients [Internet]. Jpn J Infect Dis. 2022; 75(3):234-40. DOI: 10.7883/yoken.JJID.2021.076
11. Adil B, Rabbani A, Ahmed S, Arshad I, Khalid MA. Gall Bladder Wall Thickening in Dengue Fever - Aid in Labelling Dengue Hemorrhagic Fever and a Marker of Severity [Internet]. Cureus. 2020; 12(11):e11331. DOI: 10.7759/cureus.11331
12. Ibrahim MA, Hamzah SS, Md Noor J, Mohamad MIK, Mokhtar MF, Isa MR, et al. The association of ultrasound assessment of gallbladder wall thickness with dengue fever severity [Internet]. Ultrasound J. 2022; 14(1):13. DOI: 10.1186/s13089-022-00262-w
13. Melo Valls M, Murciano Carrillo T. Interpretación del hemograma y pruebas de coagulación [Internet]. Pediatr Integral. 2012 [acceso: 21/11/2024]; 16(5): 413.e1-413.e6. Disponible en: https://www.pediatriaintegral.es/numeros-anteriores/publicacion-2012-06/interpretacion-del-hemograma/
14. Blesa Baviera LC, Vegas Álvarez AM. ¿Qué hacemos con las transaminasas? Casos clínicos [Internet]. Rev Pediatr Aten Primaria. 2021 [acceso: 21/11/2024]; 2021(30):13-8. Disponible en: https://pap.es/articulo/13185/que-hacemos-con-las-transaminasas-casos-clinicos
15. Akoglu H. User's guide to correlation coefficients [Internet]. Turkish Journal of Emergency Medicine. 2018; 18(2018):91-3. DOI: 10.1016/j.tjem.2018.08.001
16. Castañeira Rodríguez C, Feliú Mendoza D. Hallazgos ultrasonográficos en pacientes diagnosticados con dengue con signos de alarma; Hospital Provincial Clínico Quirúrgico Saturnino Lora Torres, 2022 [Internet]. UNIMED. 2023 [acceso: 22/01/2025]; 5(3):346. Disponible en: https://revunimed.sld.cu/index.php/revestud/article/view/346/html
17. Dewan N, Zuluaga D, Osorio L, Krienke ME, Bakker C, Kirsch J. Ultrasound in Dengue: A Scoping Review [Internet]. Am J Trop Med Hyg. 2021; 104(3):826-35. DOI: 10.4269/ajtmh.20-0103
18. Setiawan MW, Samsi TK, Wulur H, Sugianto D, Pool TN. Dengue haemorrhagic fever: ultrasound as an aid to predict the severity of the disease [Internet]. Pediatr Radiol. 1998; 28(1):1-4. DOI: 10.1007/s002470050281
19. Gleeson T, Pagnarith Y, Habsreng E, Lindsay R, Hill M, Sanseverino A, Patel V, Gaspari R. Dengue Management in Triage using Ultrasound in children from Cambodia: a prospective cohort study [Internet]. Lancet Reg Health West Pac. 2022; 19:100371. DOI: 10.1016/j.lanwpc.2021.100371
20. Quiroz-Moreno R, Méndez GF, Ovando-Rivera MK. Utilidad clínica del ultrasonido en la identificación de dengue hemorrágico [Internet]. Rev Med Inst Mex Seguro Soc. 2006; 44(3):243-8. Disponible en: https://www.medigraphic.com/pdfs/imss/im-2006/im063i.pdf
21. Martínez López JA. Caracterización clinicoepidemiológica y ecográfica de pacientes con dengue confirmado [Internet]. MEDISAN. 2010 [acceso: 22/01/2025]; 14(5):1-12. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192010000500011&lng=es
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Jenrry Alvarez Cruz, Darislexys Delgado Martínez, Amaya Blanco del Frade, Mara Carassou Gutiérrez, Judith Plasencia Vital, Magaly Marrero García, Niurka Alvarez Bellet, Laida María Ponce Martínez, María Caridad Guerreiro Núñez
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.
