www.ijcmr.com Section: Radiology International Journal of Contemporary Medical Research Volume 5 | Issue 6 | June 2018 | ICV: 77.83 | ISSN (Online): 2393-915X; (Print): 2454-7379 F4 Thoracic Computed Tomography Imaging in Dengue Fever: A Tertiary Experience in South Indian Population Aniruddha P Rangari 1 , Meghanaa Jayakumar 2 , Mario Jose Rodriguez 3 ORIGINAL RESEARCH ABSTRACT Introduction: Dengue fever is one of the most common acute vector-borne viral illnesses affecting mankind. Despite an abundance of case material world-wide, cross-sectional lung- imaging data in patients with dengue is scarce. The aim of the study was to detect and evaluate the thoracic CT fndings in dengue fever. Material and methods: Chest CT fndings of 30 patients with dengue fever in a 6 month period from July to December 2017 were studied. Results: The commonest chest CT fndings were pleural effusion (n=20), atelectasis (n=14), ground-glass opacifcation (n=6), patchy consolidation (n=4), air space nodules (n=3), interstitial thickening (n=3) and pericardial effusion (n=1). Conclusion: CT thorax is a good modality for evaluation of dengue patients with respiratory complaints. Frequently detected fndings on chest CT included pleural effusion, atelectasis and ground-glass opacifcation. Keywords: Viral Fever, Pleural Effusion, GGO INTRODUCTION Dengue is a mosquito-borne infection that in recent years has become a major international public health problem, especially in the tropical and sub-tropical regions 1 . In India,as of August 2017, more than 36,635 cases of dengue fever were reported according to fgures released by the National Vector-Borne Disease Control Programme. The endothelium is the primary target of immunopathological mechanisms in dengue and DHF. The hallmark is increased vascular permeability and consequent dysfunctional bleeding. These mechanisms can explain varied systemic involvement 2 . Dengue virus antigen has been found in alveolar lining cells of the lung 3 . Increased permeability of the alveolar-capillary membrane results in oedema in the alveoli and interstitial spaces. Thoracic manifestations such as pleural effusion, pneumonitis, pulmonary haemorrhage and ARDS have been reported in dengue infections 4 However, there is a paucity of clinical literature detailing CT features of dengue fever in an Indian context. The authors have attempted to demonstrate the spectrum of CT fndings in the thorax in patients with dengue. MATERIAL AND METHODS After obtaining ethical clearance, 30 Dengue seropositive patients presenting to Department of Radiodiagnosis in a tertiary hospital setting in a semi-urban location in Kerala, India over a 6-month period from July 2017 to December 2017 were included in the study. Patients were initially assessed for their symptomatology, clinical fndings and relevant lab parameters. Cases were classifed according to the 2009 WHO guidelines 5 as DF, dengue with warning signs, or severe dengue. Warning signs were abdominal pain/tenderness, persistent vomiting, fuid accumulation (pleural effusion [PE] or ascites), mucosal bleeding, liver enlargement, and increased hematocrit. The criteria for severe dengue were: severe plasma leakage; severe bleeding; severe organ involvement, comprising hepatic injury and/or renal impairment; and/or impaired consciousness. The dengue fever group comprised patients with no warning sign or criterion. Helical noncontrast CT exams of both chest and abdomen were obtained by standard protocols. The images were reviewed on lung, bone and mediastinal windows. The presence of ground-glass opacity (GGO), consolidation,airspace nodules, interlobular septal thickening, and peribronchovascular interstitial thickening were recorded based on the recommendations of the Nomenclature Committee of the Fleischner Society 6 . The presence of pleural effusion and atelectasis also were recorded. STATISTICAL ANALYSIS The data obtained was checked and entered into Microsoft Excel. The basic statistical analysis was done by SPSS Software Version 16. The level of signifcance was estimated with 95% confdence interval with ‘p’ value <0.05. RESULTS The study population comprised 10 (33.3%) females and 20 (66.7%) males aged 17–94 years (mean, 52.3 years). DF was diagnosed in 12/30 patients (7 males, 5 females) and warning signs or SD (W/SD) were diagnosed in 18/30 patients (10 males, 8 females). 1 Senior Resident, Department of Radiodiagnosis, 2 Senior Resident, Department of Radiodiagnosis, 3 Professor and HOD, Department of Radiodiagnosis, PK Das Institute of Medical Sciences, Kerala, India Corresponding author: Dr Meghanaa Jayakumar, Senior Resident,Department of Radiodiagnosis, PK Das Institute of Medical Sciences, India How to cite this article: Aniruddha P Rangari, Meghanaa Jayakumar, Mario Jose Rodriguez. Thoracic computed tomography imaging in dengue fever: a tertiary experience in South Indian population. International Journal of Contemporary Medical Research 2018;5(6):F4-F6. DOI: http://dx.doi.org/10.21276/ijcmr.2018.5.6.5