Clinical Manifestations of Dengue in Children and Adults in a Hyperendemic Region of Colombia.

Dengue is the most common arboviral disease in the world. Traditionally, it has affected more adults, but the incidence in children has increased in recent years. Colombia is no stranger to this change; therefore, we aimed to find the differences in signs, symptoms, and clinical, hematological, and hemogram characteristics between children under 12 years old and individuals aged 12 years and older in an endemic region of Colombia in 2020-2022. The analyses were conducted with baseline data, corresponding to a cross-sectional design. Multiple correspondence analysis was used for general, dermatological, and clinical symptom profiles. Discriminant analysis was used for laboratory profiles. Multiple correspondence analysis was applied to nominal categorical data, employing Euclidean distances to analyze age groups. Discriminant analysis was applied to a training sample and validated on a test sample. The overall agreement of the model's discrimination, sensitivity, specificity, and fit indicators was calculated. The results indicated that individuals under 12 years exhibited distinct dermatological and clinical features, including rash, pruritus, hypotension, lymphocyte count, and platelet count, compared with those aged 12 years and older. In contrast, those 12 years and older were profiled for general and clinical symptoms such as pain (back pain, retro-orbital pain, headache), dizziness, chills, hematuria, tachypnea, and elevated/high hematocrit, hemoglobin, and basophil values. These findings are crucial to understanding the high incidence in children; they also facilitate rapid understanding of the disease in clinical care settings and differentiate it from other febrile outbreaks. This will affect disease control, particularly in severe cases, and reduce mortality.

Density of Aedes aegypti and dengue virus transmission risk in two municipalities of Northwestern Antioquia, Colombia.

The high infestation of Aedes aegypti populations in Urabá, Antioquia, Colombia represents a risk factor for increased dengue morbidity and mortality. This study aimed to determine the risk of dengue transmission by estimating the population of Ae. aegypti using entomological indices, density of females per dwelling and inhabitant, and virological surveillance in two municipalities in Colombia. A cross-sectional study was conducted with quarterly entomological surveys in three neighborhoods of Apartadó and Turbo between 2021 and 2022. Aedes indices and vector density per dwelling and per inhabitant were calculated. The Kernel method was used for spatial analysis, and correlations between climatic variables and mosquito density were examined. Virus detection and serotyping in mosquitoes was performed using single-step reverse transcription polymerase chain reaction. The housing, reservoir, and Breteau indices were 48.9%, 29.5%, and 70.2%, respectively. The mean density of Ae. aegypti was 1.47 females / dwelling and 0.51 females / inhabitant. The overall visual analysis showed several critical points in the neighborhoods studied. There was significant correlation of vector density and relative humidity and precipitation in the neighborhoods 29 de noviembre and 24 de diciembre. Additionally, serotypes DENV-1 and DENV-2 were found. The overall indices for dwellings, reservoirs, and Breteau were lower than those recorded in 2014 in Urabá. The vector density results in this study were similar to those reported in other studies conducted in Latin America, and vector infection was detected. The Aedes and density indices are complementary, emphasizing the importance of continuous surveillance of Ae. aegypti to inform appropriate control strategies and prevent future dengue outbreaks in these municipalities.

Ischemic Stroke During Dengue Infection: A Report of 2 Cases.

BACKGROUND Involvement of the central nervous system during infection with dengue virus (DENV) is recognized. However, ischemic stroke is rarely reported. Herein are described 2 cases of patients with ischemic stroke in which DENV infection was demonstrated. CASE REPORT The first patient was a 51-year-old woman that presented altered consciousness, monoparesis, facial palsy, dysarthria, Babinski sign, and syncope 7 days from the onset of fever. She had a history of carotid artery atherothrombosis and previous stroke. Magnetic resonance imaging (MRI) showed an acute infarction of the right middle cerebral artery. DENV was confirmed by the presence of NS1 and IgM in serum. The patient was treated with intravenous fluids and recovered well, with only right facial paresis still present at discharge. The second patient was a 50-year-old man who presented with headache, altered consciousness, and mutism after a febrile episode 1 week prior. This patient had a previous history of stroke, glioblastoma resection, epilepsy, hypothyroidism, and diabetes. MRI demonstrated a subacute ischemic event. The diagnosis of dengue was confirmed by serum NS1 and IgM and by RT-PCR in serum and cerebrospinal fluid. DENV-1 serotype was observed in serum and cerebrospinal fluid. The patient was treated with intravenous fluids and was discharged in good condition. In both patients, thrombocytopenia and leukopenia was demonstrated, and hemoconcentration was demonstrated in the second patient. CONCLUSIONS In tropical and subtropical countries, DENV infection can represent a potential cause of ischemic stroke in patients with a history of comorbidities, including stroke.