O-32 Severe Dengue Cases with Multivisceral Failure Admitted to an Intensive Care Unit: A Prospective Study in Martinique
Author(s):
D Resiere , J Florentin , M Drame, R Banydeen , R Neviere
Year of Presentation:
2024
Objective: Since July 2023, the ongoing dengue epidemic in Martinique has led to over 45,000 diagnosed cases, resulting in nearly 696 hospitalizations across Martinique and Guadeloupe. Among these, 71 severe cases required intensive care unit (ICU) admission due to multivisceral failure, presenting with hematological, cardiovascular, and hepatic impairments. To date, the epidemic has directly caused 13 fatalities in these French Departments of America. This study aims to thoroughly assess the clinical characteristics and complications of severe dengue cases.
Methods: This prospective study was conducted in the medical ICU of the University Hospital of Martinique, including all patients admitted since July 2023 with a confirmed dengue diagnosis. Diagnosis was determined through early tests using gene amplification (RT-PCR) or NSI antigen detection and late tests for specific IgM and IgG antibodies. Data are presented as median [range] or percentages.
Results: From July 1 to December 10, 2023, 295 patients (140 males/155 females, median age 51 years [range 31-67]) were treated for dengue. Of these, 43% underwent RT-PCR testing, identifying serotype 2 in 100% of the cases. Overall, 114 (38%) required hospitalization, with 26 (20 males/6 females, median age 56 years [range 18 months-77 years]) presenting with severe dengue fever. Among severe dengue cases, 9 patients (35%) had pre-existing conditions, such as sickle cell disease, diabetes, heart failure, chronic alcoholism, and/or epilepsy. Six patients succumbed to complications, including multiple organ failure (33%), refractory hypoxemia (13%), and cerebral hemorrhage (8%).
Conclusion: This study highlights the potential severity of dengue fever. Key indicators of severity include acutehepatitis and significant thrombocytopenia. Despite intensive care efforts, the mortality rate is 30%, emphasizing the need for ongoing research and vigilance to manage severe dengue cases during epidemics.