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Correspondence

Indian Pediatr 2017;54: 1058

Neonatal Dengue Infection

 

Sriram Pothapregada

Department of Pediatrics, Indira Gandhi Medical College and Research Institute, Puducherry, India.
Email: [email protected]

 


A 23-year-old woman with term pregnancy was admitted in our hospital with high fever, headache and myalgia for 7 days. Dengue NS1 antigen and IgM antibodies against dengue virus were positive, whereas IgG antibody test was negative. She delivered on the 3rd day of admission, and had severe postpartum hemorrhage, subconjuctival hemorrhage, and bilateral pleural effusion. Severe thrombocytopenia was present (platelet count 8×10
9/L). Repeated transfusions of blood, fresh frozen plasma and platelets were needed. Platelet count started rising on the 4th postnatal day, and after that she gradually recovered. A female baby was delivered vaginally on day-6 of maternal illness; birth weight was 2.7 kg, and APGAR scores were 7/10 and 9/10 at 1 and 5 minutes, respectively. Baby developed fever on day-3; the sepsis screen was negative. Dengue NS1 antigen was positive, and IgM and IgG antibody tests were negative. Blood culture was sterile. The fever initially settled but again appeared on day-10, and the infant had refusal of feeds, tachypnea, tachycardia, hepatomegaly and lethargy. Intravenous fluids were administered. Petechial lesions were noted on day-11; platelet count was 10×109/L. Platelet transfusions and supportive management were provided. Baby recovered well and was discharged on day-20 of life on breast feeds.

Dengue fever presenting in neonatal period is unusual [1-3]. During the dengue fever epidemics, if a pregnant woman gets primary infection in late pregnancy and delivers at the height of viremia, both the mother and newborn are at risk of life- threatening complications [4]. A newborn with dengue infection should be vigilantly monitored for the warning signs well into the second week of life before being considered for discharge, especially during epidemics.

References

1. Choudhary SP, Gupta RK, Kishan J. Dengue shock syndrome in newborn-A case series. Indian Pediatr. 2004;41:397-9.

2. Petdachal W, Sila’on J, Nimmannitya S, Nisalak A. Neonatal dengue infection: report of dengue fever in a 1-day old infant. Southeast Asian J Trop Med Public Health. 2004;35:403-7.

3. Chin PS, Khoo APC, Asma Hani AW, Chem YK, Norijah I, Chua KB. Acute dengue in neonate secondary to perinatal transmission. Med J Malaysia. 2008;63:265-6.

4. Maroun SL, Marliere RC, Barcellus RC, Barbosa CN, Ramos JR, Moreira ME, et al. Case report: vertical dengue infection. J Pediatr (Rio J). 2008;84:556-9.


 

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