Mucocutaneous Manifestations in Patients with Dengue Fever: From the EPIDENGUE Cohort on Reunion Island
DOI:
https://doi.org/10.2340/actadv.v104.40334Keywords:
Dengue fever, Skin manifestations, ReunionAbstract
Nearly 4 billion people live in a dengue risk area worldwide. The prevalence of dengue-related mucocutaneous manifestations and their association with severe dengue differ across studies. The aim of the study was to describe the characteristics of patients with dengue-related mucocutaneous manifestations and to investigate those were associated with severe dengue. A retrospective study was conducted in 2019 among patients with a positive RT-PCR for dengue at the University Hospital of Reunion, which has been experiencing a re-emergence of dengue since 2018. Of 847 patients with confirmed dengue, 283 (33.4%) developed mucocutaneous manifestations. Only manifestations of dehydration such as glossitis, dysgeusia, or conjunctivitis were associated with severe dengue, unlike pruritus and rash, in bivariate analysis but not in multivariate analysis. The rash and pruritus of dengue appear to be accompanied by a pronounced flu-like syndrome in younger people without comorbidity or severity, although careful examination of mucous membranes would better identify signs of dehydration and thus cases likely to worsen.
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References
Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, et al. The global distribution and burden of dengue. Nature 2013; 496: 504-507.
https://doi.org/10.1038/nature12060 DOI: https://doi.org/10.1038/nature12060
World Health Organization. Dengue: Guidelines for diagnosis, treatment, prevention and control: New Edition. Geneva: WHO, 2009 (cited 2024 Jun 17). Available from: http://www.ncbi.nlm.nih.gov/books/NBK143157/
Guzman MG, Gubler DJ, Izquierdo A, Martinez E, Halstead SB. Dengue infection. Nat Rev Dis Primers 2016; 2: 16055.
https://doi.org/10.1038/nrdp.2016.55 DOI: https://doi.org/10.1038/nrdp.2016.55
Waterman SH, Gubler DJ. Dengue fever. Clin Dermatol 1989; 7: 117-122.
https://doi.org/10.1016/0738-081X(89)90034-5 DOI: https://doi.org/10.1016/0738-081X(89)90034-5
Braun M, Andersen LK, Norton SA, Coates SJ. Dengue: updates for dermatologists on the world's fastest-growing vector-borne disease. Int J Dermatol 2023; 62: 1110-1120.
https://doi.org/10.1111/ijd.16739 DOI: https://doi.org/10.1111/ijd.16739
Mishra AK, George AA, Abhilash KPP. The relationship between skin rash and outcome in dengue. J Vector Borne Dis 2018; 55: 310-314.
https://doi.org/10.4103/0972-9062.256567 DOI: https://doi.org/10.4103/0972-9062.256567
Hafsia S, Haramboure M, Wilkinson DA, Baldet T, Yemadje-Menudier L, Vincent M, et al. Overview of dengue outbreaks in the southwestern Indian Ocean and analysis of factors involved in the shift toward endemicity in Reunion Island: a systematic review. PLoS Negl Trop Dis 2022; 16: e0010547.
https://doi.org/10.1371/journal.pntd.0010547 DOI: https://doi.org/10.1371/journal.pntd.0010547
Santé Publique France. Surveillance de la dengue à La Réunion. Point au 7 décembre 2021 (Internet) [cited 2024 Jun 17]. Available from: https://www.santepubliquefrance.fr/regions/ocean-indien/documents/bulletin-regional/2021/surveillance-de-la-dengue-a-la-reunion.-point-au-7-decembre-2021
Fera C, Maillard O, Joly E, Diallo K, Mavingui P, Koumar Y, et al. Descriptive and comparative analysis of mucocutaneous manifestations in patients with dengue fever: a prospective study. J Eur Acad Dermatol Venereol 2024 38: 191-196.
https://doi.org/10.1111/jdv.19453 DOI: https://doi.org/10.1111/jdv.19453
Maillard O, Belot J, Adenis T, Rollot O, Adenis A, Guihard B, et al. Early diagnosis of dengue: diagnostic utility of the SD BIOLINE Dengue Duo rapid test in Reunion Island. PLoS Negl Trop Dis 2023; 17: e0011253.
https://doi.org/10.1371/journal.pntd.0011253 DOI: https://doi.org/10.1371/journal.pntd.0011253
Carras M, Maillard O, Cousty J, Gérardin P, Boukerrou M, Raffray L, et al. Associated risk factors of severe dengue in Reunion Island: a prospective cohort study. PLoS Negl Trop Dis 2023; 17: e0011260.
https://doi.org/10.1371/journal.pntd.0011260 DOI: https://doi.org/10.1371/journal.pntd.0011260
Yuan K, Chen Y, Zhong M, Lin Y, Liu L. Risk and predictive factors for severe dengue infection: a systematic review and meta-analysis. PLoS One 2022; 17: e0267186.
https://doi.org/10.1371/journal.pone.0267186 DOI: https://doi.org/10.1371/journal.pone.0267186
Sangkaew S, Ming D, Boonyasiri A, Honeyford K, Kalayanarooj S, Yacoub S, et al. Risk predictors of progression to severe disease during the febrile phase of dengue: a systematic review and meta-analysis. Lancet Infect Dis 2021; 21: 1014-1026.
https://doi.org/10.1016/S1473-3099(20)30601-0 DOI: https://doi.org/10.1016/S1473-3099(20)30601-0
Tsheten T, Clements ACA, Gray DJ, Adhikary RK, Furuya-Kanamori L, Wangdi K. Clinical predictors of severe dengue: a systematic review and meta-analysis. Infect Dis Poverty 2021; 10: 123.
https://doi.org/10.1186/s40249-021-00908-2 DOI: https://doi.org/10.1186/s40249-021-00908-2
Htun TP, Xiong Z, Pang J. Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis. Emerg Microbes Infect 2021; 10: 1116-1128.
https://doi.org/10.1080/22221751.2021.1935327 DOI: https://doi.org/10.1080/22221751.2021.1935327
de Andino RM, Botet MV, Gubler DJ, García C, Laboy E, Espada F, et al. The absence of dengue virus in the skin lesions of dengue fever. Int J Dermatol 1985; 24: 48-51.
https://doi.org/10.1111/j.1365-4362.1985.tb05360.x DOI: https://doi.org/10.1111/j.1365-4362.1985.tb05360.x
King CA, Wegman AD, Endy TP. Mobilization and activation of the innate immune response to dengue virus. Front Cell Infect Microbiol 2020; 10: 574417.
https://doi.org/10.3389/fcimb.2020.574417 DOI: https://doi.org/10.3389/fcimb.2020.574417
Harris E, Pérez L, Phares CR, Pérez M de los A, Idiaquez W, Rocha J, et al. Fluid intake and decreased risk for hospitalization for dengue fever, Nicaragua. Emerg Infect Dis 2003; 9: 1003-1006.
https://doi.org/10.3201/eid0908.020456 DOI: https://doi.org/10.3201/eid0908.020456
Lee I-K, Lee W-H, Yang KD, Liu J-W. Comparison of the effects of oral hydration and intravenous fluid replacement in adult patients with non-shock dengue hemorrhagic fever in Taiwan. Trans R Soc Trop Med Hyg 2010; 104: 541-545.
https://doi.org/10.1016/j.trstmh.2010.05.003 DOI: https://doi.org/10.1016/j.trstmh.2010.05.003
Besnard O, Maillard O, Franco J-M, Lebreton N, Reix G, Legrand F, et al. Hydration and clinical warning signs of dengue fever in primary care: an observational prospective study. Infect Dis Now 2023; 53: 104708.
https://doi.org/10.1016/j.idnow.2023.104708 DOI: https://doi.org/10.1016/j.idnow.2023.104708
Morsy S, Hashan MR, Hieu TH, Mohammed AT, Elawady SS, Ghosh P, et al. The association between dengue viremia kinetics and dengue severity: a systemic review and meta-analysis. Rev Med Virol 2020; 30: 1-10.
https://doi.org/10.1002/rmv.2121 DOI: https://doi.org/10.1002/rmv.2121
Lowell BA, Froelich CW, Federman DG, Kirsner RS. Dermatology in primary care: pPrevalence and patient disposition. J Am Acad Dermatol 2001; 45: 250-255.
https://doi.org/10.1067/mjd.2001.114598 DOI: https://doi.org/10.1067/mjd.2001.114598
Thomas EA, John M, Kanish B. Mucocutaneous manifestations of dengue fever. Indian J Dermatol 2010; 55: 79-85.
https://doi.org/10.4103/0019-5154.60359 DOI: https://doi.org/10.4103/0019-5154.60359
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Copyright (c) 2024 Olivier Maillard, Clotilde Fera, Elisa Joly, Kevin Diallo, Patrick Mavingui, Yves-Marie Diarra, Yatrika Koumar, André Cabié, Antoine Bertolotti
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European Regional Development Fund
Grant numbers 20202640-0022937