González-Díaz E, Cruz-Neri RU, Morfín-Otero M, Álvarez-Martínez M, Rimoldi-Carbajal V, Pérez-Gómez HR, Gómez- Quiroz P, Vázquez-León M, Castillo-Moran MA, León-Garnica G, Petersen-Morfín S, Rodríguez-Noriega E

Idioma: Español
Referencias bibliográficas: 53
Paginas: 44-54
Archivo PDF: 405.65 Kb.

RESUMEN

Antecedentes: El dengue en México afecta a toda su geografía. Los 4 virus en co-circulación provocan diferentes presentaciones clínicas, hasta casos graves. En 2009 una epidemia de dengue ocurrió en la zona metropolitana de Guadalajara, Jalisco, México, acompañando a la pandemia de influenza por H1N1pdm09. En el Hospital Civil de Guadalajara, “Fray Antonio Alcalde”, se implementó un sistema de puntaje para dengue que en conjunto con un sistema para influenza ayudo a diferenciar ambas patologías. Método: A los adultos mayores o iguales a 18 años que acudieron con un síndrome febril agudo inespecífico (SFAI) durante abril-diciembre 2009 se les aplico dos sistemas de puntaje. Se evaluaron 5653 pacientes con SFAI, de estos 3593 tuvieron un puntaje positivo para influenza y 2060 para dengue. Los especímenes de sangre se procesaron para antígenos NS1 y serologías IgG e IgM para los virus 1-4 del dengue, así como muestras de secreción nasofaríngeos para RCP-TRr para Influenza. Resultados: Pacientes con dengue tuvieron una edad mayor que los de influenza, 33.75 años vs. 30.73 años (p=0.027). La duración con fiebre antes de acudir a atención medica fue de 3.31 días en pacientes con dengue vs. 2.75 días en pacientes con influenza (‹0.011). La fiebre, cefalea y mialgias, fue mayor en los pacientes con dengue que en los pacientes con influenza, 99.4% vs. 85.2%, 98.1% vs. 88.4%, 98.1% vs.81.9%, respectivamente. Ocurrió más trombocitopenia, leucopenia y linfocitopenia en dengue que en los pacientes con influenza. Conclusiones: El sistema de puntaje en SFAI, para influenza y dengue es de gran utilidad clínica y ayuda al diagnóstico oportuno y tratamiento temprano.

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