Acute Dengue Fever in a Neonate Secondary to Perinatal Transmission

Document Type : Case Report

Authors

Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

Abstract

Background: Dengue in pregnancy is associated with adverse maternal and fetal outcomes, including perinatal transmission.
Case report: We report a case of neonatal dengue in a baby born to a 29-year-old primigravida at 38 weeks of gestation. She developed acute dengue fever 2 days prior to delivery. Her dengue nonstructural protein 1 antigen was reactive. She delivered a term baby girl via spontaneous vaginal delivery. Her fever persisted in the post-partum period which was associated with post-partum hemorrhage, altered coagulation, and liver function. She was clinically diagnosed to have hemophagocytic lymphohistiocytosis complicated with disseminated intravascular coagulation and treated with intravenous (IV) dexamethasone and multiple blood products, including fresh frozen plasma and platelet concentrate. She recovered in over the next 5 days. The baby girl was born with a birth weight of 3040g and developed fever on the third day of life with poor perfusion, associated with mottling and hypotension. The baby was treated with IV fluids, inotropes, and supportive care. The fever subsided after 48 h, along with clinical improvement, but continued with thrombocytopenia. The baby did not have any bleeding. Platelet recovery started on the 11th postnatal day (i.e., the 8th day of illness), and platelet count was normalized at 2 weeks. Dengue serology immunoglobulin M by enzyme-linked immunosorbent assay was positive for both mother and baby. The clinical diagnosis was confirmed by laboratory tests.
Conclusion: Dengue fever in mothers very late in pregnancy can cause symptomatic dengue infection in neonates.
 
 

Keywords


  1. Brady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG, et al. Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis. 2012;6(8):e1760
  2. Malhotra N, Chanana C, Kumar S. Dengue infection in pregnancy. Int J Gynaecol Obstet. 2006;
    94(2):131-2.
  3. Perret C, Chanthavanich P, Pengsaa K, Limkittikul K, Hutajaroen P, Bunn JE, et al. Dengue infection during pregnancy and transplacental antibody transfer in Thai mothers. J Infect. 2005;51(4):287-93.
  4. Phongsamart W, Yoksan S, Vanaprapa N, Chokephaibulkit K. Dengue virus infection in late pregnancy and transmission to the infants. Pediatr Infect Dis J. 2008;27(6):500-4.
  5. Waduge R, Malavige GN, Pradeepan M, Wijeyaratne CN, Fernando S, Seneviratne SL. Dengue infections during pregnancy: a case series from Sri Lanka and review of the literature. J Clin Virol. 2006;
    37(1):27-33.
  6. Pouliot SH, Xiong X, Harville E, Paz-Soldan V, Tomashek KM, Breart G,et al. Maternal dengue and pregnancy outcomes: a systematic review. Obstet Gynecol Surv. 2010;65(2):107-18.
  7. Paixão ES, Teixeira MG, Costa MD, Rodrigues LC. Dengue during pregnancy and adverse fetal outcomes: a systematic review and meta-analysis. Lancet Infect Dis. 2016; 16(7):857-65.
  8. Carroll ID, Toovey S, Van Gompel A. Dengue fever and pregnancy: a review and comment. Travel Med Infect Dis. 2007;5(3):183-8.
  9. Sirinavin S, Nuntnarumit P, Supapannachart S, Boonkasidecha S, Techasaensiri C, Yoksarn S. Vertical dengue infection: case reports and review. Pediatr Infect Dis J. 2004;23(11):1042-7.

10. Nisalak A. Laboratory diagnosis of dengue virus infections.Southeast Asian J Trop Med Public Health.2015;46(1):55-76.