Serotype specific differences among inpatient and outpatient dengue fever patients at a tertiary care hospital in Western Maharashtra.

BACKGROUND

Dengue fever remains a significant public health concern, with clinical presentations and serotype prevalence varying across regions. This study aimed to evaluate the clinical spectrum, serotype distribution, and complications associated with dengue fever in adult patients at a tertiary care hospital in Western Maharashtra.

METHODS

A prospective observational study was conducted between June 2022 and June 2024, enrolling 250 adult patients with acute febrile illness and NS1 antigen-positive testing for dengue. Clinical and laboratory data, including dengue serotyping, complete hemogram, liver function tests, and imaging for serositis, were collected. Standardized World Health Organization (WHO) definitions were used for complications such as thrombocytopenia, transaminitis, bleeding manifestations, and postural hypotension.

RESULTS

Fever (100%), headache (76%), myalgia (63.2%), and gastrointestinal symptoms (nausea and vomiting 46%, abdominal pain 26.8%). The most common clinical manifestations were fever dengue virus 2 (DENV2) was the predominant serotype (60%), followed by DENV1 (22.8%) and DENV3 (6%). Multiserotype infections accounted for 9.6% of cases. Thrombocytopenia was observed in 65% of patients, with severe thrombocytopenia (<50,000/μL) in 20%. Transaminitis occurred in 32.8%, and bleeding manifestations were noted in 22.4% of cases. Multiserotype infections were significantly associated with increased incidence of bleeding, serositis, and postural hypotension (p = 0.009).

CONCLUSION

DENV2 was the most prevalent serotype, followed by DENV1 in our study. The presence of multiserotype infections associated with more severe clinical outcomes, including bleeding and organ involvement. Molecular serotyping in high-risk cases and vigilant clinical monitoring in these patients is critical for patient management, outbreak preparedness, and future vaccine strategies.