Perinatal Transmission of Dengue: A Case Report
Loading...
Date
2020-10
Journal Title
Journal ISSN
Volume Title
Publisher
Akshantala Enterprises Private Limited
Abstract
A single, male neonate was born at 36 weeks of gestation with birth weight of 2.62 Kg, to a 24-year-old primigravida mother by LSCS in an outside hospital. Apgar score at 1 min and 5 mins were 7 and 9 respectively and he was shifted to mother’s side. On day 4 of life, he developed respiratory distress and decreased oral intake and was referred to our neonatal tertiary care unit (NICU).Maternal antenatal history was uneventful. Mother had fever and thrombocytopenia and was diagnosed as dengue infection (Dengue NS 1 antigen and Ig M positive) 3 days before delivery and managed at same hospital.On admission, baby had respiratory rate of 64 / min, mild retractions, SpO2 of 92 % on room air and mild hepatomegaly. Cardiovascular system seemed to be normal but poor activity and sucking was there. He was started on IV fluids, antibiotics and non-invasive respiratory support. Chest X-ray was normal. Haemoglobin was 18.3 gm / dL, total leukocyte count of 4600 / mm3, absolute neutrophil count of 2681, platelet count of 1.5 lac, haematocrit of 50.8 % and C reactive protein of 7.7. Dengue NS1 antigen and IgM came out to be positive. There was no evidence of mosquito bite in neonate postnatally.Infant’s clinical condition deteriorated with increased requirement of respiratory support and SpO2 up to 40 %. Platelet count further fell to 59000 on day 2 and 13000 on day 3 of hospital stay and was managed with multiple platelet transfusions. Baby also had features of third space loss. Repeat chest X-ray suggestive of right pleural effusion and ultrasound abdomen showed mild ascites and mild hepatomegaly. But cranial ultrasound was also done which was normal. No evidence of bleeding during hospital stay. Baby was managed initially with fluids and first line antibiotics as per the unit protocol. Orogastric feeds were started as baby had clinical improvement which were built up gradually and baby switched to spoon feeds after 7 days. Baby was weaned off from respiratory support as requirement decreased. Baby was discharged with improving platelet count and absence of features of third space loss. On discharge baby was hemodynamically stable and accepting oral feed.Dengue is a systemic arthropod borne and transmitted systemic viral infection which is an emerging disease in many states of India. Major mode of transmission of dengue is mosquito bite but vertical transmission is rarely seen.1 There are some reported cases of dengue infection in pregnancy and association with many complications in neonate like low birth weight, perinatal mortality, foetal distress and preterm birth. The samples from foetal or cord blood are considered as a better source of qualifying dengue infection in utero.2 In neonates, vertical transmission of dengue from mother can produce varying symptoms ranging from fever with thrombocytopenia to intracranial haemorrhage.3As India is a resource limited country the survey for dengue cases in neonates is not done in a schematic manner, there are only a few case reports of neonatal dengue infection from India and its vertical transmission. Here we are reporting a case of vertical transmission of dengue in a neonate at our Neonatal ICU.
Description
Keywords
Citation
Kaur Navjot, Mangal Dhananjay K, Gupta Sushil, Singhal Chanchal, Kaler Gajinder Pal Singh. Perinatal Transmission of Dengue: A Case Report. Journal of Evolution of Medical and Dental Sciences. 2020 Oct; 9(42): 3167-3168