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Indian Pediatr 2017;54: 1058 |
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Neonatal Dengue Infection
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Sriram Pothapregada
Department of Pediatrics, Indira Gandhi Medical College
and Research Institute, Puducherry, India.
Email: [email protected]
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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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