Perinatal dengue infection.

We report a case of vertical transmission of dengue infection in an infant. The mother's was a term pregnancy with a history of chronic hypertension. She presented with high fever of 3 days duration 5 days prior to delivery. Her initial complete blood count showed platelet count of 64,000/mm3. Dengue hemorrhagic fever was diagnosed 2 days later and symptomatic treatment was given. During labor her platelets dropped to 11,000/mm3 and platelet concentrate was given. Cesarean section was performed due to prolonged second stage of labor. Her infant was normal at birth except for petechiae on the left thigh. The child's platelet count was 34,000/mm3 and low grade fever was detected on the first day. Clinical sepsis was suspected and antibiotic treatment was started and continued for 4 days until all the cultures came back as negative. Both mother and her baby made an uneventful recovery and were discharged 6 days after delivery with normal platelet counts. Maternal blood was positive for IgM antibody to dengue virus. Both cord blood and the baby's blood were positive for dengue virus serotype 2 by PCR.

Flow cytometric detection of intracellular cytokines in peripheral blood of HIV-1 infected Thai children.

The objective of this study was to determine changes in Th1/Th2 cytokine production at the cellular level which occur during the progression of HIV-1 subtype E infection in Thai children born to HIV-1 subtype E infected mothers. Mitogen stimulated whole blood cultures from 12 uninfected and 27 HIV-1 subtype E infected Thai children were stained intracellularly with fluorescein labelled monoclonal antibodies against Interleukin (IL)-2 and IFN-gamma (Th1 cytokines) and IL-4 (Th2 cytokine). Additionally, co-staining of CD4+ and CD8+ T cells was performed. Results were analyzed by two and three color flow cytometry. The percentage of IFN-gamma expressing cells in CD4+ T cells was increased in HIV-1 subtype E infected Thai children with mild and moderate immunosuppression (Immunological categories 1 + 2, Centers for Diseases Control and Prevention (CDC) staging system, 1994). The percentages of IFN-gamma expression was continuously enhanced accompanied by remaining preserved in the proportion of IL-2 producing T cells in HIV-1 subtype E infected Thai children with severe immunosuppression (Immunological category 3, CDC staging system, 1994). The percentages of IFN-gamma expression was continuously augmented whereas the proportion of IL-2 producing T cells remained unchanged in HIV-1 subtype E infected Thai Children with severe immunosuppression (immunological category 3, CDC staging system, 1994). The percentage of Th2 cytokine producing cells within the CD4+ ad CD8+ T cells increased in HIV-1 subtype E infected individuals and showed a significant difference in HIV-1 subtype E infected Thai children with AIDS compared with uninfected infants. These results suggest that in vertically acquired HIV-1 infection with severe immunosuppression, the percentages of IL-2 producing CD4+ T cell was consistent but the percentages of IL-4 and IFN-gamma producing cell were increased. Similar results were found for CD8+ T cells in which IL-4 producing cells were increased in conjunction with a remaining in the number of IL-2 producing cells in HIV-1 subtype E infected Thai children. Thus, changes in the Th1 and Th2 cytokine pattern during HIV-1 infection may contribute to the prognosis of HIV disease in children.