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Volume 14, Number 3—March 2008

Letter

Dengue Virus, Nepal

Basu Dev Pandey*Comments to Author , Kouichi Morita†, Santa Raj Khanal‡, Tomohiko Takasaki§, Isao Miyazaki¶, Tetsuro Ogawa¶, Shingo Inoue†, and Ichiro Kurane¶
Author affiliations: *Tropical and Infectious Disease Hospital, Kathmandu, Nepal; †Nagasaki University, Nagasaki, Japan; ‡Tribhuban University, Kathmandu, Nepal; §National Institute of Infectious Diseases, Tokyo, Japan; ¶Pentax Company Limited, Tokyo, Japan;

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Table

Patient age, y/Sex Month admitted Location Initial 
diagnosis Travel history Clinical signs and symptoms Selected laboratory and other test results
20/M Sep Kathmandu DF Yes Fever, headache, nausea Hb 15.4 g/dL; TLC 10,500/mm3; 
Plt 185,000/mm3; blood culture for salmonellae negative; ALT 38 IU/L
27/F Sep Bardiya Viral fever No Fever, headache, vomiting TLC 5,600/mm3; blood culture for salmonellae negative
3/M Sep Salayan Encephalitis No Fever, vomiting, convulsions Widal negative; TLC 4,700/mm3
13/M Oct Sindhuli Typhoid fever No Fever, headache Widal negative; TLC 4,500/mm3; blood culture for salmonellae negative; Brucella antigen negative; chest radiograph normal
22/M Oct Birgunj DHF No Fever, headache, vomiting, ascites Bil 0.8 mg/dL; ALT 80 IU/L; Plt 22,000/mm3; chest radiograph normal
55/F Oct Dang DF No Fever, headache, muscular pain Plt 51,000/mm3; TLC 7,600/mm3; MP negative; ESR 20 mm/h; Bil 0.7 mg/dL
22/F Oct Birgunj Viral fever No Fever, headache, 
body ache Brucella negative; Widal negative; 
TLC 5,600/mm3
13/M Nov Dang DF No Fever, headache, rashes Plt 95,000/mm3; TLC 4,700/mm3; 
Hb 13.1 g%; Bil 0.8mg/dL; ALT 26 IU/L
35/F Nov Birgunj DHF No Fever, headache, bruises; tourniquet: positive Bil 0.81mg/dL; Plt 31,000/mm3; 
PT 2 min 30 s (control 14)
40/M Nov Birgunj DF No Fever, headache, rashes ALT 127IU/L; Plt 110,000 /mm3; 
PCV 38.8%;TLC 5,500/mm3; ultrasonography liver size, 16.8 cm
42/M Nov Dang DF No Fever, headache, rashes Bil 0.7 mg/dL; Widal test negative; 
TLC 6,800/mm3; Plt 164,000/mm3

*Blood specimens were collected at time of hospital admission. Diagnosis was confirmed by using immunoglobulin M–capture ELISA. DF, dengue fever; Hb, hemoglobulin;TLC, total leukocyte count; Plt, platelets; ALT, alanine aminotransferase; DHF, dengue hemorrhagic fever Bil, bilirubin; MP, malaria parasites; ESR, erythrocyte sedimentation rate; PT, prothrombin time; PCV, packed cell volume.

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