Clinical profile of patients presenting with acute febrile illness during monsoon season for 3 successive years - A cross sectional observational study

A BSTRACT Background: Acute febrile illness (AFI) is the common presentation in tropical countries like India, particularly during the monsoon season. The diagnostic challenge in resource-limited settings often leads to presumptive management without identifying the specific etiology. Understanding the clinical spectrum and etiology of AFI is crucial for timely diagnosis and effective treatment. Objectives: To evaluate the clinical, biochemical, and radiological profiles of adult patients admitted with acute febrile illness during the monsoon months over three consecutive years and to identify the prevalent infections and their outcomes. Methods: This cross-sectional observational study was conducted at a tertiary care hospital in Nagpur during the monsoon months (June to September) for three successive years (2022-2024). A total of 300 adult patients presenting with fever of less than 14 days duration were included after obtaining informed consent. Clinical history, examination, and relevant laboratory and radiological investigations were performed. The etiology was confirmed using serological tests, blood cultures, and imaging. Treatment and outcomes were recorded. Results: Out of the total 300 patients, dengue fever was the most common diagnosis (33%), followed by lower respiratory tract infections (12%), acute gastroenteritis (11.4%), upper respiratory tract infections (10.7%), and malaria (7.8%). Other etiologies included urinary tract infection, enteric fever, scrub typhus, acute viral hepatitis, meningitis/encephalitis, and leptospirosis. In 8.5% of cases, the etiology remained unidentified. Most patients responded well to empirical therapy, and the overall outcome was favorable with low mortality. Conclusion: Dengue remains the predominant cause of AFI during the monsoon season, followed by bacterial and protozoal infections. Accurate etiological diagnosis supported by appropriate investigations can help reduce morbidity. The findings emphasize the need for improved diagnostic facilities and seasonal surveillance to manage AFI effectively in endemic regions.