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Med Mal Infect. 2010 Aug;40(8):480-9. doi: 10.1016/j.medmal.2009.10.001. Epub 2009 Nov 29.

Prospective and descriptive study of adult dengue cases in an emergency department, in Martinique.

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  • 1CIC-EC 802 Inserm, service des urgences, centre d'investigation clinique et d'épidémiologie clinique Antilles-Guyane, centre hospitalier universitaire, 97200 Fort-de-France, Martinique.



Knowing about the clinical aspects of dengue in endemic zones is essential to implementation of appropriate case management protocols and public health interventions.


The authors made a 4-year prospective, observational study of dengue-infected patients admitted to the emergency department of the Fort-de-France University Hospital.


Two hundred and sixty-three male and 297 female patients were included. The median age was 37 years (range: 14-91). The diagnosis was based on a positive RT-PCR (463 patients) or on the presence of specific IgM (97 patients). Two hundred and seventy-seven patients (49.5%) presented with dengue fever without complications. According to WHO criteria, 95 patients (17%) developed plasma leakage, including 39 patients (7%) diagnosed with DHF, and 10 (1.8%) diagnosed with DSS. Among the other patients without plasma leakage, 84 (15%) had isolated thrombocytopenia, 14 (2.5%) had internal bleeding, and 90 (16%) had unusual manifestations. Seven patients died (1.3%): fulminant hepatitis (two), myocarditis (one), encephalitis (one), acute respiratory failure (one), gangrenous cholecystitis (one), and post-traumatic intracranial hemorrhage (one). The other patients recovered. Seven patients were pregnant (1.3%) from 6 to 27 weeks of amenorrhea and carried their pregnancy to term without complications.


With this experience, we were able to develop appropriate case management protocols for patients during dengue epidemics.

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