INTRACRANIAL HEMORRHAGE IN PREMATURE INFANT OF LOWEST WEIGHT WITH CONGENITAL DENGUE: A CASE REPORT
Keywords:Vertical Transmission, dengue infection, premature baby, thrombocytopenia
We report a case of congenital dengue in the smallest patient with dengue vertical transmission reported in the literature to date. A premature infant was admitted to a neonatal intensive care unit at San Francis Hospital, Francisco Beltrão, Brazil (2012) with suspected dengue infection owing to thrombocytopenia, confirmed by ELISA detection of anti-dengue specific IgM. The patient received four transfusions of 15ml/kg body weight (BW) of packed red cells and 15 mm3 /kg BW platelets. On Day 13 post-admission platelet counts reached a minimal level (28x103 /mm3 ) and gradually returned to normal (165x103 / mm3 ) on the 20th day of life, by which time the patient had also gained weight. Transfontanelar ultrasound performed on Day 19 showed marked hydrocephalus, brain hemorrhage grade III and ventriculitis. On Day 23, the patient presented a convulsive crisis, which required mechanical ventilation and subsequently developed pneumonia, sepsis and renal failure; and expired on Day 38. We discuss the importance of examining the clinical history of mothers of premature newborns with thrombocytopenia, especially in regions where dengue is endemic.