Table 1.
Criteria for severe dengue according to World Health Organization guidelines 1997 and 2009.
Figure 1.
Ultrasonography findings showing presence or absence of ascites in dengue patients.
Handheld ultrasonography performed at the bedside with the patient in supine position during examination. (A) Normal hepatic-renal area. (B) Minimal ascites in hepato-renal area (arrow). (C) Normal spleno-renal area. (D) Ascites in spleno-renal area (arrow). Abbreviations: L: liver; K: kidney, RLL: right lower lobe of lung; LLL: left lower lobe of lung; S: Spleen.
Figure 2.
Ultrasonography findings showing a normal and thickened gallbladder wall in dengue patients.
Handheld ultrasonography performed at the bedside with the patient in supine position during examination. (A) normal gallbladder wall (<0.30 cm) (B) and thickened gallbladder wall. The gall bladder wall is thickened with 0.90 cm and has a subserosal fluid layer, giving the gallbladder wall a multiple layer aspect. Abbreviations: L: liver; GB: gallbladder lumen.
Figure 3.
Ultrasonography findings showing presence or absence of pleural effusion in dengue patients.
Handheld ultrasonography at the bedside with patient in supine position during examination. (A) Normal right costophrenic angle. (B) Pleural effusion in the right costophrenic angle (arrow). Abbreviations: L: liver; K: kidney, RLL: right lower lobe of lung.
Table 2.
Patient characteristics and baseline data for non-severe and severe dengue patients.
Table 3.
Ultrasonography findings of plasma leakage and hemoconcentration in non-severe and severe dengue patients.
Figure 4.
Hematocrit values in dengue patients with and without subclinical plasma leakage detected by handheld ultrasonography.
(A) Absolute hematocrit values (%) (Normal maximum hematocrit value 50% and 44% for men and women, respectively) related to the presence or absence of plasma leakage detected by handheld ultrasonography on the day of enrollment. (B) Changes in hematocrit (%) related to the presence or absence of plasma leakage during the follow up of adult Indonesian dengue patients. Plasma leakage was detected in the form of ascites or pleural effusion by daily handheld ultrasonography at the bedside performed by a clinician and by conventional ultrasonography. The black dots indicate patients who developed severe dengue characterized by shock. The horizontal continuous lines represent median values. The horizontal interrupted line represents the reference value for hematocrit change (normally <20% change) P-values were determined by unpaired t-test for hematocrit values and by Mann Whitney U test for hematocrit changes. * p value<0.05; ** p value<0.01.