Ultrasound Findings in Dengue Fever: A Growing Public Health Concern

 Dengue fever has become one of the most alarming public health issues in tropical and subtropical regions, including Pakistan. Transmitted by the Aedes aegypti mosquito, dengue can progress rapidly from mild fever to severe, life-threatening conditions such as Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS).

  While laboratory tests confirm the diagnosis, ultrasound imaging plays a vital role in the early detection of complications and in monitoring disease progression, especially in settings where laboratory facilities are limited.

Why Ultrasound Matters in Dengue?

 Ultrasound is a non-invasive, quick, and cost-effective imaging method. It helps identify plasma leakage and fluid accumulation, which are key indicators of severe dengue. Early sonographic assessment can assist clinicians in preventing complications such as shock, liver failure, or internal bleeding.

The most common sonographic findings seen in dengue fever:

1. Gallbladder Wall Thickening

   • The earliest and most consistent ultrasound finding.

   • Thickness >3 mm is considered abnormal.

   • May appear as a “double wall” or “honeycomb” pattern due to edema.

2. Ascites

   • Free fluid in the hepatorenal, spleno renal, or pelvic cavities.

   • Indicates plasma leakage; commonly seen in DHF cases.

3. Pleural Effusion

   • Usually right-sided; appears as an anechoic or hypoechoic fluid layer.

   • In severe dengue, it may become bilateral.

4. Hepatomegaly

   • The liver appears enlarged and sometimes shows coarse echotexture due to inflammation.

5. Splenomegaly

   • Enlarged spleen, often mild to moderate.

6. Pericholecystic or Perinephric Fluid

   • Reflects plasma leakage in severe disease stages.

7. Collapsed Inferior Vena Cava (IVC)

   • Suggests hypovolemia or dehydration — an important warning sign for shock.

Ultrasound Tips for Sonographers and Clinicians

• Perform ultrasound in a fasting state when possible for accurate gallbladder measurement.

• Always document ascitic and pleural fluid with precise measurements.

• Compare findings with hematological data like platelet count and hematocrit levels.

• Re-evaluate patients daily in severe cases to monitor progression or improvement.

• Use point-of-care ultrasound (POCUS) in emergency or field settings to aid timely diagnosis.

Public Health Importance

Dengue outbreaks are increasing every year due to urbanization, poor sanitation, and climate change. Ultrasound, though often underutilized in public health response, can serve as a rapid screening tool in hospitals and community clinics.

Early imaging helps in:

• Reducing hospital admissions through early triage.

• Identifying complications before they become critical.

• Supporting national surveillance data with imaging-based evidence.

Healthcare providers, radiologists, and public health professionals should collaborate to train sonographers in recognizing these early signs

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