FREQUENCY OF SUPERIMPOSED BACTERIAL INFECTIONS IN PATIENTS PRESENTING WITH DENGUE FEVER

Abstract

Background: Dengue fever is a significant public health challenge in endemic regions, often complicated by secondary bacterial infections which increase the severity and prolong hospitalization. These co-infections not only raise morbidity and mortality rates but also strain healthcare systems, especially during seasonal outbreaks. Early identification of such infections using laboratory markers is critical to improving clinical outcomes and guiding appropriate treatment strategies in resource-limited settings.

Objective: To determine the frequency of superimposed bacterial infections among patients diagnosed with dengue fever.

Methods: This comparative cross-sectional study was conducted at the Department of Medicine, Combined Military Hospital, Jhelum, from April to September 2024. A total of 250 adult patients admitted with confirmed dengue infection were included using non-probability consecutive sampling. Patients with chronic inflammatory diseases, immunosuppression, or pregnancy were excluded. Serum procalcitonin, C-reactive protein (CRP), and total leukocyte count (TLC) were measured to identify bacterial co-infections. Procalcitonin >2.0 ng/ml, CRP >12 mg/L, TLC >12 × 10⁹/µL, or positive blood culture were considered diagnostic indicators. Data analysis was performed using SPSS version 24.

Results: Out of 250 patients, 157 (62.8%) were male and 93 (37.2%) female. The median age was 58 years (IQR 22). Median procalcitonin, CRP, and TLC values were 0.3 ng/ml (IQR 1.1), 4.8 mg/L (IQR 7.0), and 5.0 × 10⁹/µL (IQR 8.9), respectively. Based on diagnostic criteria, 27 patients (10.8%) were found to have superimposed bacterial infections.

Conclusion: Secondary bacterial infections in dengue patients are clinically significant and demand a high index of suspicion. Timely recognition using simple laboratory tests can facilitate early intervention, reducing complications and hospital stay.