인도에서 귀국한 가족에서 발생한 심한 고혈당 동반 소아 뎅기열 1례
A Pediatric Case of Dengue Fever with Extreme Hyperglycemia Developed in a Family Who Returned from India
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초록
뎅기열은 풍토성을 가지며 주로 열대 및 아열대지역에서 많이 발생하는 질환이고 우리나라는 발병 지역은 아니다. 발열, 발진, 두통 등의 비특이적 증상을 보이는 해외에서 돌아온 여행자를 만나는 경우 해외유입감염병을 의심해야 한다. 지속되는 구토, 복통, 출혈 경향, 간효소수치 상승, 단백뇨 등은 뎅기열에서 심한 뎅기열로의 진행의 위험인자로 알려져 있다. 심각한 고혈당은 다양한 급성 질환에서 나쁜 예후와 관련이 있고 당뇨병 등 고혈당으로 증상이 나타날 수 있는 기저질환이 동반된 경우는 심각한 뎅기열로의 진행과도 관련이 있다고 알려져 있다. 저자들은 인도에서 귀국한 청소년에서 발생한 심한 고혈당을 동반한 뎅기열을 경험하였다. 이와 함께 한국에서 보고된 소아 뎅기열 증례들을 고찰하여 보고하는 바이다.
Abstract
Dengue fever (DF) is endemic throughout tropical and subtropical regions; however, it is not endemic in Korea. Imported infectious diseases should be suspected when encountering returned travelers with non-specific symptoms such as fever, rash, and headache. Persistent vomiting, abdominal pain, hemorrhagic tendency, hepatic enzyme abnormalities, and proteinuria are risk factors for the development of severe DF in a patient with DF. Severe hyperglycemia is also known to be related to poor prognosis in acute illness, and with certain underlying diseases that present with hyperglycemia, such as diabetes, it is related to the progression of severe DF. We report a DF case with severe hyperglycemia in an adolescent returning from India. Pediatric DF cases reported in Korea were also reviewed.
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