Abstract：
BACKGROUND: Dengue is a mosquito-borne viral infection that typically occurs in tropical and subtropical countries. The clinical manifestations of dengue infection range from an asymptomatic subclinical course to severe dengue shock syndrome. Besides, dengue can affect any organ in the body and can present with atypical manifestations.
METHODS: We report a 6-year-old previously healthy Tamil child who had dengue complicated with multiorgan involvement. She initially presented with high fever, headache, body aches for 5 days, blood and mucus diarrhea, hematuria, and right knee joint swelling for 2 days. Dengue NS1 antigen was positive on day 2 of febrile illness. She was managed symptomatically in the local hospital for 3 days and transferred to the tertiary care hospital for further management. She was eventually diagnosed as having dengue hemorrhagic fever complicated with multiorgan involvement including acute liver failure, pancreatic involvement, coagulopathy, arthritis, acute kidney injury, and multiple intracranial hemorrhages. The constellation of disease manifestations was identified as expanded dengue syndrome. She was managed with fresh blood, platelet, and cryoprecipitate transfusions and intravenous antibiotics in addition to renal and liver support in the intensive care unit. On day 14 of illness, she deteriorated while on the ventilator and died due to multiple intracranial hemorrhages.
CONCLUSIONS: The reported child with dengue hemorrhagic fever developed several unusual presentations such as acute liver and renal failure, disseminated intravascular coagulopathy, pancreatic involvement, and multiple intracranial hemorrhages, which form part of expanded dengue syndrome. In the seriously unwell child, it is important to look for unusual complications actively to improve outcomes.
METHODS: We report a 6-year-old previously healthy Tamil child who had dengue complicated with multiorgan involvement. She initially presented with high fever, headache, body aches for 5 days, blood and mucus diarrhea, hematuria, and right knee joint swelling for 2 days. Dengue NS1 antigen was positive on day 2 of febrile illness. She was managed symptomatically in the local hospital for 3 days and transferred to the tertiary care hospital for further management. She was eventually diagnosed as having dengue hemorrhagic fever complicated with multiorgan involvement including acute liver failure, pancreatic involvement, coagulopathy, arthritis, acute kidney injury, and multiple intracranial hemorrhages. The constellation of disease manifestations was identified as expanded dengue syndrome. She was managed with fresh blood, platelet, and cryoprecipitate transfusions and intravenous antibiotics in addition to renal and liver support in the intensive care unit. On day 14 of illness, she deteriorated while on the ventilator and died due to multiple intracranial hemorrhages.
CONCLUSIONS: The reported child with dengue hemorrhagic fever developed several unusual presentations such as acute liver and renal failure, disseminated intravascular coagulopathy, pancreatic involvement, and multiple intracranial hemorrhages, which form part of expanded dengue syndrome. In the seriously unwell child, it is important to look for unusual complications actively to improve outcomes.
摘要：
背景：登革热是一种蚊子传播的病毒感染，通常发生在热带和亚热带国家。登革热感染的临床表现范围从无症状的亚临床病程到严重的登革热休克综合征。此外,登革热可以影响身体的任何器官，并且可以表现为非典型的表现。
方法：我们报告了一名6岁以前健康的泰米尔儿童，他患有登革热并伴有多器官受累。她最初发高烧，头痛,身体疼痛5天，血液和粘液腹泻，血尿,右膝关节肿胀2天。登革热NS1抗原在热病第2天呈阳性。她在当地医院接受了3天的对症治疗，并转移到三级保健医院进行进一步治疗。她最终被诊断为登革热出血热并发多器官受累，包括急性肝功能衰竭，胰腺受累,凝血病,关节炎,急性肾损伤，和多发性颅内出血.疾病表现的星座被确定为扩大的登革热综合征。她是用新鲜血液管理的，血小板,在重症监护病房，除了肾脏和肝脏支持外，还进行冷沉淀输血和静脉注射抗生素。在疾病的第14天，她在使用呼吸机时病情恶化，死于多次颅内出血。
结论：报道的登革热出血热患儿出现了几种不寻常的表现，如急性肝和肾衰竭，播散性血管内凝血病,胰腺受累,和多发性颅内出血,构成登革热扩大综合征的一部分。在严重不适的孩子中，积极寻找异常并发症以改善结局非常重要.
方法：我们报告了一名6岁以前健康的泰米尔儿童，他患有登革热并伴有多器官受累。她最初发高烧，头痛,身体疼痛5天，血液和粘液腹泻，血尿,右膝关节肿胀2天。登革热NS1抗原在热病第2天呈阳性。她在当地医院接受了3天的对症治疗，并转移到三级保健医院进行进一步治疗。她最终被诊断为登革热出血热并发多器官受累，包括急性肝功能衰竭，胰腺受累,凝血病,关节炎,急性肾损伤，和多发性颅内出血.疾病表现的星座被确定为扩大的登革热综合征。她是用新鲜血液管理的，血小板,在重症监护病房，除了肾脏和肝脏支持外，还进行冷沉淀输血和静脉注射抗生素。在疾病的第14天，她在使用呼吸机时病情恶化，死于多次颅内出血。
结论：报道的登革热出血热患儿出现了几种不寻常的表现，如急性肝和肾衰竭，播散性血管内凝血病,胰腺受累,和多发性颅内出血,构成登革热扩大综合征的一部分。在严重不适的孩子中，积极寻找异常并发症以改善结局非常重要.
