Case of Congenital Dengue

A healthy male baby was delivered by a mother who had high fever at the time of delivery and she was subsequently diagnosed as suffering from Dengue Fever. As the baby was healthy, he was shifted to mother’s side. His complete blood counts at 48 hours was normal, and he was feeding well and activity was normal

Mother was not discharged in view of fever and hence baby was also kept under observation. He then developed Fever (temp – 102’ F) on day 4 of life and was shifted to NICU and Sepsis screen was sent along with Dengue NS1

Investigation revealed low WBC and platelet counts, CRP too was positive and Dengue NS 1 Positive. The baby was treated on lines of Dengue Fever management. IV Antibiotic was started in view of CRP positive and low WBC counts. He had mild oozing from umbilicus, USG head was done to rule out intracranial bleed as platelets had reached nadir of 6000.

Baby was given a total of 3 RDP and 1 SDP (divided into 4 bags) over 3 to 4 days

Platelet counts simmered at less than 50,000 for a few days.

Baby developed Ascites and Edema (features that did not present in his mother) and thus Intravenous fluids were altered according to hematocrit and clinical condition.

Since platelets were taking too long to recover (more than 10 days) sepsis screen was repeated and Dengue test was repeated.

Blood Culture twice sterile – Dengue Ig M positive, NS1 negative, Ig G negative thereby confirming Congenital Dengue due to Maternal to Fetal transfer of virus.

Ascites gradually resolved, feeding improved and fluids were stopped. The baby was discharged on day 14 of life with platelet counts 61000, feeding well, no ascites and normal weight gain. On follow up platelets were 2.8 lacs.

 

Dr. Lalita Kanojiya
Senior Consultant Pediatrics
Rukmani Birla Hospital

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