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Federación Mexicana de Ginecología y Obstetricia, A.C.

2014, Number 06

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Ginecol Obstet Mex 2014; 82 (06)

Hemorrhagic dengue and vertical transmission to the newborn: a case report and literature review

Morgan-Ortiz F, Rodríguez-Lugo SM, León-Gil MS, Gaxiola-Villa M, Martínez-Félix NS, Lara-Ávila L

Language: Spanish
References: 17
Page: 401-409
PDF size: 360.41 Kb.


ABSTRACT

Objective: To describe the case of a patient with term pregnancy and infection with hemorrhagic dengue and vertical transmission to the newborn.
Clinical case: Thirty-two year old patient with pregnancy at 38 weeks was admitted with fever 2 days earlier (38° C). During her stay she continued with fever of 39°C and platelets of 85,000/mm3. Serology for dengue NS1 antigen was reported positive. Labor was induced getting a new-born, male, 3,220 g, who breathed and cried at birth. During the postpartum period continued with fever, malaise, retro-ocular pain, generalized rash in upper and lower limbs, bleeding gums and petechial on the soft palate and thrombocytopenia of 5,000/mm3, later. At 8 days of stay, platelet concentration increased to 42,000/mm3 without requiring platelet concentrates and she was discharged after ten days in hospital with platelets of 94,000/mm3.
The 4th day of extra-uterine live (EUL), neonate shows generalized rash over the trunk; The 5th day starts with 38°C fever and thrombocytopenia (78,000/mm3). Dengue serological tests reported positive for Ag NS1 and negative for Abs IgM and IgG. Neonate was admitted to NICU, he continued with a decrease in platelet of 14,000/mm3 . and ecchymotic areas by pressure and veno-punction sites. Four platelet concentrates were transfused. At 10th day of EUL platelet count was reported with 387,000/mm3.
Conclusions: In an endemic area, such as Sinaloa state, in a pregnant woman with fever and thrombocytopenia, we should be alert to possibility of a DV infection and its complications. Although rare, such as this case, infection can be transmitted to fetus (vertical transmission) and produce a primary congenital dengue, even in its severe hemorrhagic types.


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