A Study of The Clinical Profile and Pattern of Acute Febrile Illness in a Teaching Hospital in Central Mumbai
Journal Title: The Indian Practitioner - Year 2016, Vol 69, Issue 78
Abstract
AIMS AND OBJECTIVES : Fever remains the commonest cause of OPD and indoor admissions, in underdeveloped and developing countries including India. The present study was undertaken to study the fever profile, compare the aetiologies, outcome and change in pattern. MATERIAL AND METHODS: A prospective observational study was carried out on adults (>12 years), with acute undifferentiated febrile illness (temperature >38°C), within 14 days of fever, admitted between Jan and Dec 2014, in a teaching hospital in central Mumbai. 472 adult febrile cases were included and analysed as per study criteria. Clinical examination was done and laboratory data was studied and compared. Empirical polytherapy with antimalarials, symptomatic treatment for dengue and antibiotics as per clinical suspicion in high risk cases was resorted on a priority basis. RESULTS: Dengue {116 cases (24.6%)} and Malaria {95 cases (20.1%)} formed the largest group. 52 (11.1%) cases of enteric fever and 56 (11.8%) pneumonia cases were notable. 34 (7.3%) UTI cases formed a significant group (10-pyelonephritis, 8 diabetic nephropathy, 4-urolithiasis, 8-secondary to benign prostatic hypertrophy and 4 had urosepsis). This group comprised of most of the geriatric population. 2 cases of leptospirosis and 5 of hepatitis E were diagnosed. Undiagnosed cases attributed and consistent with viral infections, formed a significant group 66 (13.9 %). Overlap cases comprising co-infections and mixed infections were 46 (9.7%). The largest group (60.6%) comprised of middle aged males (31-40 years). As expected the largest number of cases (66.6 %) were recorded during the pre-monsoon and monsoon season. Bacterial and viral pathogens topped the chart (30.1% and 25.6% respectively) with the parasitic group a close second (20.6%). Overlap and undiagnosed cases formed a significant group (23.6%) (Fig-3). ICU admissions and mortality in the parasitic group was relatively high. CONCLUSION AND DISCUSSION : Dengue formed the largest group, the surge attributed to the recent indiscriminate and incomplete construction leading to increased Aedes breeding sites. Malarial fever along with respiratory and urinary infections formed a sizable group, though malaria cases were fewer, as a result of focussed malaria control. Overlap cases, co-infection and mixed infections were a significant group meriting further study. Persistent enteric and hepatitis E infections highlight the need for continued efforts at health education and sanitation. Undiagnosed febrile cases, most consistent with viral fever, underscore the need for effective diagnostic tools for detailed testing.
Authors and Affiliations
A Barua, M. E Yeolekar
Median Craniofacial Dysraphia - A Rare Occurrence
This report presents a case of 17 year old male who had congenital median incomplete cleft lip with cleft of alveolus along with bifid nose and hypertelorism suggestive of Median Craniofacial Dysraphia. Very few cases of...
Prevention of fall and fracture: Precautionary measures
.
The effect of Probiotic Bacillus subtilis HU58 on Immune function in Healthy Human
Objective: Probiotic - Bacillus subtilis is known to modulate the immune function. The current study evaluates the role of Bacillus subtilis HU58 on immune function in healthy human and also for its safety and tolerabili...
Trends of Sterilisation Amongst Rural Women
AIM: To analyse trends of tubal sterilisations performed over a period of 30 years at the rural institute of eastern Maharashtra, in relation to age, parity or abortion. To analyse the change in the trend, if any and sug...
Phenylketonuria and Mental Retardation An urgent need for availability of therapeutic diet at National Level
PKU is an autosomal recessive inborn error of amino acid metabolism (IEM) and the classic PKU disorder is characterised by a deficiency in phenylalanine hydroxylase (PAH) enzyme which is responsible for intellectual disa...