We report a case of vertical transmission of dengue infection in a new born from Bangladesh. The mother was primigravida with an uneventful antenatal period except the fever she developed at 37 weeks of gestation. She underwent cesarean section for decreased fetal movement. The fever lasted for 7 days and was associated with intense bodyache, and a positive tourniquet test. She did not experience any hemorrhages including from the surgical wound. Her platelet count fell at its lowest to 100,000/mm3. She had bilateral mild pleural effusions and positive anti-dengue antibodies (both IgG and IgM). She received symptomatic treatment. The baby was deeply meconium stained and was resuscitated by a pediatrician. His postnatal period went well until day-3 of life when he developed fever and respiratory distress. There were no signs of meconiun aspiration syndrome (MAS) and the septic work up was negative. The platelets count fell to its lowest of 40,000/mm3 on day-3 and day-5 of his illness. Anti-dengue antibodies (both IgG and IgM) were positive with a nearly four-fold rise of IgM antibodies in the convalescent sera. The boy was treated with platelet transfusions and was discharged on day-6 after becoming ill. This report emphasizes that in a dengue epidemic or when dengue is endemic (which Bangladesh has experienced recently), a pregnant woman with fever, myalgia and/or bleeding manifestations should raise a high suspicion that the baby may develop the disease, and both the mother and baby should be closely followed-up. Viral isolation could not be done due to the unavailability of the test.

译文

我们报告了一例孟加拉国新生儿登革热感染的垂直传播病例。母亲是初产妇,产前平稳,除了在妊娠37周时发热。她因胎动减少而接受剖宫产。发热持续了7天,并伴有强烈的身体疼痛和止血带测试阳性。她没有经历任何出血,包括手术伤口。她的血小板计数最低降至100,000/mm3。患者双侧轻度胸腔积液,抗登革热抗体 (IgG和IgM) 阳性。她接受了对症治疗。婴儿的胎粪染色很深,并由儿科医生进行了复苏。他的产后一直很顺利,直到生命的第3天发热和呼吸窘迫。没有甲虫吸入综合征 (MAS) 的迹象,脓毒症检查为阴性。在他患病的第3天和第5天,血小板计数降至最低40,000/mm3。抗登革热抗体 (IgG和IgM) 呈阳性,恢复期血清中的IgM抗体增加了近四倍。该男孩接受了血小板输注治疗,并在生病后第6天出院。该报告强调,在登革热流行或登革热流行 (孟加拉国最近经历过) 时,发热,肌肉疼痛和/或出血表现的孕妇应高度怀疑婴儿可能会患上这种疾病,并且母亲和婴儿都应密切随访。由于无法进行测试,因此无法进行病毒分离。

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