International Journal of Contemporary Pediatrics | September-October 2017 | Vol 4 | Issue 5 Page 1866 International Journal of Contemporary Pediatrics Matti M et al. Int J Contemp Pediatr. 2017 Sep;4(5):1866-1870 http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291 Original Research Article Comparison of morbidity and mortality between serologically positive and serologically negative dengue cases Mahantesh Matti, Mahesh B. Maralihalli*, Shilpa Dinesh, INTRODUCTION Dengue is the most rapidly spreading mosquito-borne viral disease in the world, with 30 fold increase in the incidence since last 50 years. Reported case fatality rates in south-east Asia is approximately 1%, but in India, Indonesia and Myanmar, focal outbreaks away from the urban areas have reported case-fatality rates of 3-5%. 1 Dengue is a disease caused by an arbovirus, which has four related virus serotypes (DENV-1, DENV-2, DENV- 3, and DENV-4). Dengue is a systemic and dynamic infectious disease. The infection may be asymptomatic or present itself with a broad clinical spectrum that includes both severe and non-severe clinical manifestations. There are other viral infections, bacterial infections like leptospirosis which clinically mimic dengue fever.In most of the hospitals clinical diagnosis is confirmed solely by dengue serology using rapid Immunochromatographic test or Rapid diagnostic tests (RDT) for NS1Ag, IgM and IgG antibodies against dengue serotypes, which have good sensitivity and specificity. 2 In our intensive care unit we have noted children with clinically diagnosed severe dengue (Group C of WHO)cases, who were tested negative for dengue ABSTRACT Background: Dengue is most common arboviral disease caused by 4 types of dengue viruses. In most of the hospitals laboratory diagnosis is made by dengue serology using Rapid Immunochromatographic Test for NS1Ag, IgM and IgG antibodies. We found more morbidity and mortality in suspected dengue cases whose serology was negative for dengue. Methods: Children with clinical features suggestive for case definition for dengue, who belonged to group C of World Health organisation (WHO) guidelines for dengue fever (severe dengue), were included. They were categorised into dengue positive and dengue negative groups. The clinical features and complications of the disease between the two groups were compared. Results: 98 cases (77.8%) were serologically positive for dengue and 28 (22.2%) were negative. 39% of the patients with dengue negative serology developed hypotensive shock in comparison to 18% of dengue positive cases, mortality in serology negative cases (21%) was significantly higher than positive cases (8%). Conclusions: We could not find the reasons for more morbidity and mortality in seronegative dengue group, we stress up on improving the sensitivity and specificity of rapid diagnostic tests. More caution need to be taken for serology negative dengue cases. Epidemiological studies directed to find circulation of other viruses which causes dengue like symptoms should be made. Keywords: Dengue, Rapid diagnostic tests, Serology Department of Pediatrics, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India Received: 11 May 2017 Accepted: 05 August 2017 *Correspondence: Dr. Mahesh B. Maralihalli, E-mail: drmaheshmaralihalli@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20173801