Table 3. Comparison of clinical and laboratory features of primary versus secondary dengue in children and adults, June 2012- May 2013, southern Sri Lanka.
| Adults | Children | |||||
|---|---|---|---|---|---|---|
| Characteristic | Primary dengue n = 69 |
Secondary dengue n = 203 |
p-value | Primary dengue n = 34 |
Secondary dengue n = 42 |
p-value |
| Age | 30.3 (24.2–43.8) | 34.1 (26.5–46.1) | 0.11 | 10.2 (5.0–15.9) | 13.3 (8.2–16.1) | 0.19 |
| Male | 45 (65.2%) | 135 (66.5%) | 0.85 | 24 (70.6%) | 22 (52.4%) | 0.11 |
| Symptom | ||||||
| Days of fever | 4 (3–5) | 5 (3–6) | 0.01 | 4 (2–5) | 5 (5–6) | < .001 |
| Rhinitis/congestion | 10 (14.5%) | 15 (7.4%) | 0.08 | 12 (35.3%) | 6 (14.3%) | 0.03 |
| Sore throat | 11 (15.9%) | 33 (16.3%) | 0.95 | 11 (33.3%) | 8 (19.1%) | 0.16 |
| Cough | 33 (47.8%) | 65 (32.5%) | 0.02 | 14 (41.2%) | 15 (35.7%) | 0.63 |
| Joint pain | 41 (59.4%) | 163 (81.1%) | < .001 | 13 (40.6%) | 26 (61.9%) | 0.07 |
| Muscle pain | 40 (58.5%) | 157 (77.3%) | 0.003 | 14 (43.8%) | 28 (66.7%) | 0.049 |
| Anorexia | 64 (92.8%) | 186 (92.1%) | 0.86 | 29 (85.3%) | 38 (90.5%) | 0.49 |
| Abdominal pain | 20 (29.0%) | 46 (22.8%) | 0.30 | 14 (41.2%) | 18 (43.9%) | 0.81 |
| Vomiting | 29 (42.7%) | 110 (56.7%) | 0.046 | 18 (52.9%) | 28 (70.0%) | 0.13 |
| Diarrhea | 7 (10.1%) | 29 (14.4%) | 0.37 | 3 (8.8%) | 0 (0%) | 0.05 |
| Dysuria | 5 (7.3%) | 25 (12.3%) | 0.25 | 5 (14.7%) | 4 (9.8%) | 0.51 |
| Oliguria | 10 (14.7%) | 25 (12.3%) | 0.61 | 2 (5.9%) | 9 (22.0%) | 0.05 |
| Headache | 60 (87.0%) | 166 (82.2%) | 0.36 | 21 (65.6%) | 32 (78.1%) | 0.24 |
| Fatigue | 56 (82.4%) | 158 (78.6%) | 0.51 | 26 (78.8%) | 40 (97.6%) | 0.01 |
| Signs | ||||||
| Temperature | 100.6 (99.2–101.0) | 99.8 (98.8–100.8) | 0.04 | 99.5 (98.4–100.8) | 100.3 (99.0–100.8) | 0.27 |
| Heart rate/ min | 80 (76–88) | 80 (72–92) | 0.76 | 98 (88–110) | 96 (82–100) | 0.26 |
| Systolic BP | 110 (110–120) | 110 (100–120) | 0.15 | 100 (90–110) | 110 (100–110) | 0.04 |
| Diastolic BP | 70 (70–80) | 70 (70–80) | 0.44 | 60 (60–70) | 70 (60–70) | 0.24 |
| Conjunctival injection | 16 (23.2%) | 30 (14.8%) | 0.11 | 6 (17.7%) | 0 (0%) | 0.005 |
| Pharyngeal erythema/ exudate | 4 (11.8%) | 1 (2.4%) | 0.10 | 7 (10.1%) | 17 (8.4%) | 0.65 |
| Lymphadenopathy | 9 (13.4%) | 18 (9.2%) | 0.32 | 9 (26.5%) | 7 (16.7%) | 0.30 |
| Jaundice | 0 (0%) | 2 (1.0%) | 0.41 | 0 | 0 | — |
| Lung crackles | 6 (8.7%) | 4 (2.0%) | 0.01 | 2 (5.9%) | 1 (2.4%) | 0.44 |
| Right upper abdominal tenderness | 8 (11.8%) | 32 (15.9%) | 0.41 | 8 (24.2%) | 6 (14.6%) | 0.29 |
| Hepatomegaly | 6 (8.8%) | 15 (7.5%) | 0.73 | 3 (8.8%) | 1 (2.4%) | 0.22 |
| Rash | 6 (8.7%) | 41 (20.2%) | 0.03 | 6 (17.7%) | 12 (28.6%) | 0.27 |
| Flushing | 3 (4.4%) | 28 (13.8%) | 0.03 | 4 (11.8%) | 10 (23.8%) | 0.18 |
| Laboratory parameter | Median IQR | |||||
| WBC per μL | 3.5 (2.5–6.7) | 3.4 (2.4–5.1) | 0.29 | 7.3 (4.0–10.8) | 2.5 (2.2–3.8) | < .001 |
| Leukopenia* | 39 (56.5%) | 127 (62.9%) | 0.35 | 7 (23.3%) | 32 (78.1%) | < .001 |
| ANC# per μL | 2.5 (1.5–4.7) | 2.1 (1.3–3.7) | 0.09 | 4.8 (1.7–6.2) | 1.3 (0.9–2.0) | < .001 |
| ALC^ per μL | 0.7 (0.5–1.1) | 0.7 (0.5–0.9) | 0.67 | 1.2 (0.7–2.8) | 0.8 (0.6–1.3) | 0.009 |
| Hemoglobin (g/dl) | 13.7 (12.5–14.7) | 13.6 (12.4–14.7) | 0.63 | 12.9 (11.8–13.9) | 12.9 (12.2–13.5) | 0.91 |
| Hematocrit | 41.0 (37.0–44.1) | 40.3 (37.1–43.7) | 0.65 | 38.8 (35.5–40.6) | 38.6 (37.2–41.0) | 0.71 |
| Platelets (x1000/ /μL)* | 130 (88–175) | 103 (60–150) | 0.003 | 204 (139–261) | 84 (59–124) | < .001 |
| Thrombocytopenia* | 21 (30.4%) | 99 (49.0%) | 0.007 | 6 (20.0%) | 23 (56.1%) | 0.002 |
| Elevated transaminases+ | 2 (2.9%) | 17 (8.4%) | 0.12 | 1 (2.9%) | 3 (7.1%) | 0.42 |
| Antibiotics at enrollment | 34 (49.3%) | 79 (38.9%) | 0.13 | 11 (32.4%) | 15 (35.7%) | 0.76 |
* Within 48 hrs of Admission
#Absolute neutrophil count.
^Absolute lymphocyte count.
+ within 7 days. Leukopenia: <4 x 103 cells/μL. Thrombocytopenia: <100 x 103/μL. Elevated transaminases: AST or ALT > 120 IU, 3 times upper limit of normal). Number (proportions) listed in table except WBC and platelet count, which are listed as median (IQR).