Dengue en paciente de 32 días de vida. Reporte de un caso poco habitual / Dengue fever in a 32-day-old patient. A rare case report

El dengue es una enfermedad viral transmitida por la picadura del mosquito Aedes aegypti. El comportamiento del dengue en Argentina es epidémico; la mayoría de los casos se observan en los meses de mayor temperatura. Hasta la semana epidemiológica (SE) 20/2023, se registraron en Argentina 106 672 casos; se vieron afectadas 18 de las 24 provincias que conforman el país. Dentro de los principales grupos de riesgo, se incluyen los menores de 2 años. Reconocer los signos, síntomas e identificar los factores de riesgo es fundamental para el manejo de casos con mayor riesgo de gravedad. Presentamos el caso de una paciente de 32 días de vida que se internó por síndrome febril sin foco, con diagnósticos diferenciales de meningitis viral y sepsis, evolucionó con leucocitosis, plaquetopenia, hipoalbuminemia, asociado a exantema y edemas. Se llegó al diagnóstico de dengue por la clínica, epidemiologia e IgM positiva.

Dengue fever is a viral disease transmitted by the Aedes aegypti mosquitoes. In Argentina, dengue fever is an epidemic disease; most cases are reported during the hot months.Until epidemiological week (EW) 20/2023, 106 672 cases were reported across 18 of the 24 provinces of Argentina. Children younger than 2 years are among the main groups at risk. Recognizing signs and symptoms and identifying risk factors is fundamental for the management of cases at a higher risk of severity. Here we describe the case of a 32-day-old female patient who was hospitalized due to febrile syndrome without a source, who had a differential diagnosis of viral meningitis and sepsis and progressed to leukocytosis, thrombocytopenia, hypoalbuminemia in association with rash and edema. The diagnosis of dengue fever was established based on clinical, epidemiological, and positive IgM data.

Monitoramento dos casos de arboviroses no Estado de Goiás da semana epidemiológica 01 a 06 de 2024 / Monitoring of arbovirus cases in Goiás in epidemiological week of 06 at 24 de 2024

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também são apresentados dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The arbovirus epidemiological bulletin aims to present the epidemiological situation of cases in the state, using records of suspected and confirmed cases as a data source. occurred in recent years, available on Sinan Online and Sinan Net. Data relating to congenital syndrome associated with Zika Virus infection are also presented, available on the Public Health Event Registration System (RESP) - Microcephalies

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica de 01 a 50 de 2023 / Epidemiological bulletin: monitoring of arbovirus cases in Goiás from epidemiological week 01 to 50 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também são apresentados dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The arbovirus epidemiological bulletin aims to present the epidemiological situation of cases in the state, using records of suspected and confirmed cases as a data source. occurred in recent years, available on Sinan Online and Sinan Net. Data relating to congenital syndrome associated with Zika Virus infection are also presented, available on the Public Health Event Registration System (RESP) - Microcephalies

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica 01 a 44 de 2023 / Epidemiological bulletin: monitoring of arbovirus cases in Goiás from epidemiological week 01 to 44 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também são apresentados dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The arbovirus epidemiological bulletin aims to present the epidemiological situation of cases in the state, using records of suspected and confirmed cases as a data source. occurred in recent years, available on Sinan Online and Sinan Net. Data relating to congenital syndrome associated with Zika Virus infection are also presented, available on the Public Health Event Registration System (RESP) - Microcephalies

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica 01 a 34 de 2023 / Epidemiological bulletin: monitoring of arbovirus cases in Goiás from epidemiological week 01 to 34 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também são apresentados dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The arbovirus epidemiological bulletin aims to present the epidemiological situation of cases in the state, using records of suspected and confirmed cases as a data source. occurred in recent years, available on Sinan Online and Sinan Net. Data relating to congenital syndrome associated with Zika Virus infection are also presented, available on the Public Health Event Registration System (RESP) - Microcephalias

Boletim epidemiológico: monitoramento dos casos de arboviroses em Goiás da semana epidemiológica 01 a 25 de 2023 / Epidemiological bulletin: monitoring of cases of arboviruses in Goiás from the epidemiological week 01 to 25 of 2023

As arboviroses transmitidas pelo mosquito Aedes aegypti são um dos principais problemas de saúde pública no Estado de Goiás. O boletim epidemiológico das arboviroses tem o objetivo de apresentar a situação epidemiológica dos casos no estado, utilizando como fonte de dados os registros de casos suspeitos e confirmados ocorridos nos últimos anos, disponíveis no Sinan Online e Sinan Net. Também é apresentado dados relativos à síndrome congênita associada à infecção pelo Zika Vírus, disponíveis no Sistema de Registro de Eventos em Saúde Pública (RESP) - Microcefalias

Arboviruses transmitted by the Aedes aegypti mosquito are one of the main public health problems in the State of Goiás. The epidemiological bulletin of arboviruses aims to present the epidemiological situation of cases in the state, using as a data source the records of suspected and confirmed cases that occurred in recent years, available on Sinan Online and Sinan Net. It also presents data related to the congenital syndrome associated with Zika Virus infection, available in the Public Health Event Registration System (RESP) - Microcephaly

Encefalitis como complicación neurológica por dengue / Encephalitis as neurological complication due dengue

Resumen Se presenta el caso de un varón de 32 años, previamente sano, que consultó por fiebre de cinco días, cefalea, dolor retro-ocular, rash, petequias, mialgias, artralgias y dolor abdominal. Presentaba leucopenia, trombocitopenia intensa, transaminitis y tiempo de coagulación prolongado. Se diagnosticó un dengue grave con coagulopatía que requirió manejo en Unidad de Cuidados Intensivos. Evolucionó con alteración del estado de conciencia, agitación psicomotora y agresividad. Se descartaron alteraciones estructurales, isquémicohemorrágicas, infecciones bacterianas y micóticas. Se confirmó finalmente una encefalitis por dengue por una RPC para virus dengue positiva en LCR. Se brindaron medidas de soporte con una evolución favorable. La encefalitis es la complicación neurológica más grave tras la infección por virus del dengue.

Abstract We present the case of a 32-year-old male, previously healthy, with a 5-day history of fever, frontal-occipital headache, retro-ocular pain, rash, petechiae, myalgia, arthralgia, and abdominal pain. Blood tests with leukopenia, severe thrombocytopenia, transaminitis, long clotting times. Severe dengue with associated coagulopathy was diagnosed, indicating transfer to ICU. Presents torpid evolution, altered state of consciousness, psychomotor agitation, and aggressiveness. Structural, ischemic-hemorrhagic alterations, bacterial and fungal infections were ruled out. Finally diagnosing dengue encephalitis, confirmed by DENV PCR in CSF. Support measures are provided with favorable evolution. Encephalitis is the most serious neurological complication after dengue virus infection.

Detecção de arboviroses em gestantes na região noroeste do Estado de São Paulo / Detection of arboviroses in pregnant women in the northwest region of the state of São Paulo

As infecções ocasionadas pelos vírus da Dengue (DENV), Zika (ZIKV) e Chikungunya (CHIKV) em gestantes são de grande preocupação pelos possíveis danos causados pelos mesmos às mães e fetos. O ZIKV está relacionado à microcefalia e outras anomalias cerebrais graves em neonatos e a infecção por CHIKV em gestantes no período intraparto pode levar à transmissão vertical, com possibilidade de agravamento no quadro do neonato. E, apesar de ainda não haver relatos de ocorrência de malformações congênitas associadas à infecção por DENV em gestantes, as mesmas são consideradas um grupo de risco, pois apresentam maiores chances de evolução para formas graves ou óbito e aumento no risco de partos prematuros decorrente da infecção materna perinatal. Neste estudo, foi realizada uma análise retrospectiva dos resultados envolvendo os vírus DENV, ZIKV e CHIKV para determinar a taxa de positividade destas arboviroses em gestantes no município de São José do Rio Preto-SP, nos anos de 2018 e 2019. Para isso, foram coletados resultados de PCR em tempo real (RT-PCR) para DENV, ZIKV e CHIKV de amostras de soro e urina obtidas de 557 gestantes com histórico de febre, bem como 93 amostras de recém-nascidos (RN). Na análise dos resultados foi verificado que o sorotipo-2 de Dengue (DENV-2) foi detectado em 106/557 correspondendo a 19% das amostras, o sorotipo-1 (DENV-1) foi detectado em apenas uma amostra e o ZIKV foi detectado em duas amostras. CHIKV não foi detectado. Não foi detectado arbovírus nas amostras de RN testadas pela técnica de RT-PCR. Quanto à idade, 40% das gestantes pertenciam à faixa etária de 25 a 32 anos, seguidas pelas faixas de 33 a 40 anos e 17 a 24 anos com percentuais de 31 e 29%, respectivamente. No período, uma gestante que estava na 13ª semana de gestação foi a óbito por DENV-2. Os resultados obtidos evidenciam a importância do diagnóstico precoce das arboviroses neste grupo, viabilizando a assistência adequada às gestantes. Nesse sentido, o monitoramento da circulação simultânea de arboviroses responsáveis por causarem complicações em gestantes e infecções congênitas deve continuar em áreas endêmicas como a de São José do Rio Preto, visando um diagnóstico materno precoce e manejo adequado de gestantes testadas positivas verificando a presença de sinais de alerta e de dengue grave.

Infections caused by Dengue (DENV), Zika (ZIKV) and Chikungunya (CHIKV) viruses in pregnant women represent great concern because of the possible damage that can be caused by these viruses to both mothers and fetuses. ZIKV is related to microcephaly and other severe brain abnormalities in neonates, while CHIKV infection in pregnant women in the intrapartum period can lead to vertical transmission, with the possibility of worsening in the neonate. And although there are no reports of congenital malformations associated with DENV infection in pregnant women, they are also considered of risk group, since they have greater probability to progress to severe forms or even death. In addition, there is an increased risk of premature childbirth. In this study, a retrospective result analysis involving DENV, ZIKV and CHIKV viruses was carried out to determine the positivity rate of those arboviruses in pregnant women in the city of São José do Rio Preto-SP, in the years 2018 and 2019. For this purpose, real-time PCR results (RT-PCR) were collected for DENV, ZIKV and CHIKV from serum and urine samples obtained from 557 pregnant women with a history of fever, as well as samples from 93 newborns (NB). Dengue serotype-2 (DENV-2) was detected in 106/557, which corresponds to 19% of the samples; dengue serotype-1 (DENV-1) was detected in only one sample, and the ZIKV was detected in two samples. CHIKV was not detected. Arboviruses were not detected in the NB samples tested by the RT-PCR technique. In relation to age groups, 40% of pregnant women were between 25 to 32 years old, followed by the groups of 33 to 40 years old, and 17 to 24 years old, with 31% and 29%, respectively. In the period, a pregnant woman who was in the 13th week of pregnancy died due to DENV-2. The results obtained emphasize the importance of the early diagnosis of arboviruses in this group, thus enabling adequate assistance to pregnant women. In this sense, the monitoring of arboviruses circulation responsible for causing complications and congenital infections in pregnant women should continue in endemic areas such as São José do Rio Preto, aiming at an early maternal diagnosis and adequate management of the patients who tested positive, checking for the presence of any alert signs and severe dengue.

Características clínicas de los pacientes con fiebre manchada de las Montañas Rocosas, infección por dengue y chikungunya / Clinical features of patients with Rocky Mountain spotted fever, dengue and chikungunya infection

Resumen Introducción: La distinción clínica entre infecciones arbovirales y las provocadas por rickettsias es crucial para iniciar el tratamiento médico apropiado. Objetivo: Comparar las diferencias entre fiebre manchada de las Montañas Rocosas (FMMR) y otras enfermedades transmitidas por vector (dengue y chikungunya) con presentación clínica similar e identificar los datos que pudieran ayudar al diagnóstico rápido de esas enfermedades. Métodos: Se evaluaron datos sociodemográficos, clínicos y de laboratorio de 399 pacientes de cinco hospitales y clínicas en Sonora, México, entre 2004 y 2016, con el diagnóstico confirmado por laboratorio de FMMR, dengue o chikungunya. Resultados: El grupo con FMMR presentó la mayor letalidad (49/63 muertes, 77.8 %), seguido por el de chikungunya (3/161, 1.9 %) y el de dengue (3/161, 1.9 %). Las diferencias clínicas consistieron en la presencia de exantema, edema y prurito; además, se documentaron diferencias en múltiples biomarcadores como plaquetas, hemoglobina, bilirrubina indirecta y niveles de sodio sérico. Conclusión: El exantema en palmas y plantas, edema y ausencia de prurito, aunados a niveles altos de bilirrubina directa y trombocitopenia severa pudieran ser indicadores útiles para diferenciar a pacientes con FMMR en etapas avanzadas de aquellos con dengue y chikungunya.

Abstract Introduction: Clinical distinction between arbovirus infections and those caused by rickettsia is crucial to initiate appropriate medical treatment. Objective: To compare the differences between Rocky Mountain spotted fever (RMSF) and other vector-borne diseases (dengue and chikungunya) with similar clinical presentation, and to identify data that could aid rapid diagnosis of these diseases. Methods: Sociodemographic, clinical and laboratory data of 399 patients from five hospitals and clinics of Sonora, Mexico, with laboratory-confirmed diagnosis of RMSF, dengue, or chikungunya between 2004 and 2016 were evaluated. Results: The RMSF group had the highest lethality (49/63 deaths, 77.8 %), followed by the chikungunya group (3/161, 1.9 %) and the dengue group (3/161, 1.9 %). Clinical differences included the presence of rash, edema, and pruritus; in addition, differences in multiple biomarkers such as platelets, hemoglobin, indirect bilirubin, and serum sodium levels were documented. Conclusion: Rash on the palms and soles, edema and absence of pruritus, together with high levels of direct bilirubin and severe thrombocytopenia could be useful indicators to differentiate patients at RMSF advanced stages from those with dengue and chikungunya.

Dengue fever as a potential cause of sickle cell intrahepatic cholestasis: A report of two cases

Abstract Sickle cell intrahepatic cholestasis is a potentially fatal syndrome characterized by jaundice, painful hepatomegaly, and organ dysfunction. Two cases of sickle cell intrahepatic cholestasis associated with dengue fever were described. Endothelial damage/dysfunction is a mechanism involved in severe hepatobiliary complications related to sickle cell diseases. However, the reasons for the lack of increase in the admission of patients with sickle cell disease having severe acute hepatobiliary complications triggered by endothelial damage/dysfunction due to dengue fever remain unknown. This study describes the first association between sickle cell intrahepatic cholestasis and dengue fever.

Coinfección Dengue y SARS-COV-2 en paciente HIV positive / Dengue and SARS-CoV-2 coinfection in an HIV positive patient

Resumen El dengue es una arbovirosis confinada a las áreas geográficas donde habitan sus vectores, los mosquitos Aedes aegypti y Aedes albopictus. La transmisión ocurre principalmente durante el verano, pero la persistencia del insecto en el ambiente puede extenderla hasta el otoño en climas templados y cálidos. En nuestro país, este año la trasmisión estacional del dengue se superpuso temporalmente con la pandemia de COVID-19, producida por el SARS-CoV-2, un coronavirus causante de afecciones respiratorias graves con eventual desenlace fatal. Por otro lado, el HIV es un retrovirus que debilita el sistema inmune favoreciendo las infecciones por numerosos patógenos oportunistas. Presentamos el caso de un paciente con infección HIV sin tratamiento que desarrolló infección simultánea por dengue y SARS-CoV-2 con evolución favorable.

Abstract Dengue is a mosquito-borne viral disease confined to the geographical areas where its vectors Aedes aegypti and Aedes albopictus are present. The transmission occurs mainly during the summer but it can extend to autumn months in warm climates. In our country, this year the seasonal transmission of dengue overlapped with the COVID-19 pandemic, caused by SARS-CoV-2, a novel coronavirus responsible of serious respiratory conditions with eventual fatal outcomes. On the other hand, the HIV is a retrovirus that causes disease by weakening the immune system, favoring infections by numerous opportunistic pathogens. We present the case of an untreated HIV patient who developed simultaneous infection with dengue and SARS-CoV-2 with favorable evolution.

Trastornos neurológicos asociados a la infección por virus dengue / Neurological disorders associated with dengue virus infection

Introducción: Los trastornos neurológicos asociados al dengue es un tema que cobra vital importancia en estos tiempos debido a que el espectro clínico del dengue ha cambiado y las manifestaciones atípicas están reportándose con mayor frecuencia. Los serotipos 2 y 3 son los más frecuentemente relacionados a manifestaciones neurológicas como la encefalitis, mielitis y síndrome de Guillain-Barré. Objetivo: Reportar una serie de casos con trastornos neurológicos asociados a la infección por DENV y sus variables clínicas, humorales e imagenológicas. Casos clínicos: Todos los pacientes cursaron en primera instancia con un cuadro clínico de dengue no complicado dado por fiebre de 38,5º C y escalofríos de aparición brusca, exantema maculo-papuloso céfalo-caudal que respeta palmas y plantas, artralgias, mialgias, cefalea frontal y retro-ocular, esta última a la contracción del músculo recto superior del globo ocular. Todos confirmados con anticuerpos específicos anti-virus del dengue. Un paciente desarrolló síndrome de Guillain-Barré, otro curso con encefalitis, bicitopenia y compromiso del nivel de conciencia. El resto cursó con mielitis transversa, meningoencefalitis y encefalitis autoinmune. Conclusiones: Los trastornos neurológicos asociados al virus del dengue deben ser sospechados en todo paciente que ingrese con esta infección y manifieste cualquiera de las alteraciones aquí descritas(AU)

Introduction: Neurological disorders associated with dengue is an issue of vital importance in these times because the clinical spectrum of dengue has changed and atypical manifestations are being reported much frequently. Serotypes 2 and 3 are the most frequently related to neurological manifestations such as encephalitis, myelitis and Guillain-Barré syndrome. Objective: To report a series of cases with neurological disorders associated with DENV infection and its clinical, humoral and imaging variables. Clinical case report: All patients had, in the first instance, uncomplicated dengue clinical status due to 38.5º C fever and chills of sudden appearance, Cephalo-caudal maculo-papular rash that spares palms and soles, arthralgias, myalgias, frontal and retro-ocular headache, the latter due to the contraction of the superior rectus muscle of the eyeball. All confirmed with specific anti-dengue virus antibodies. One patient developed Guillain-Barré syndrome, another had encephalitis, bicytopenia, and compromised level of consciousness. The rest had transverse myelitis, meningoencephalitis and autoimmune encephalitis. Conclusions: Neurological disorders associated with dengue virus should be suspected in every patient who is admitted with this infection and manifests any of the alterations described here(AU)

Collapsing focal segmental glomerulosclerosis probably triggered by dengue virus infection - two case reports / Glomeruloesclerose Segmentar e Focal Colapsante provavelmente desencadeada por infecção pelo vírus da dengue - dois relatos de caso

Abstract The reported cases describe the association between collapsing focal segmental glomerulosclerosis (FSGS) and acute dengue virus infection. In both cases, patients were diagnosed with dengue virus infection and had a severe kidney disease, with nephrotic syndrome and acute kidney injury. Kidney biopsy was performed and showed collapsing FSGS. The first patient, a 27-year-old man, was diagnosed with dengue virus infection and developed nephrotic syndrome after two weeks of illness. He was treated with methylprednisolone for three days and intravenous furosemide. This patient evolved well, although his renal function did not fully recover. The second patient, a 32-year-old man, was diagnosed with a milder clinical presentation of dengue virus infection. He had a past medical history of nephrotic syndrome in childhood, which might have caused its relapse. This patient was treated with intravenous furosemide and also did not fully recover renal function. These cases highlight the possible implication of dengue virus infection in the etiology of collapsing variant of FSGS. Healthcare professionals should be prepared to identify similar cases.

Resumo Os casos relatados descrevem a associação entre glomeruloesclerose segmentar e focal (GESF) colapsante e infecção aguda pelo vírus da dengue. Nas duas instâncias os pacientes foram diagnosticados com infecção pelo vírus da dengue e apresentaram doença renal grave, com síndrome nefrótica e insuficiência renal aguda. A biópsia renal revelou a presença de GESF colapsante. O primeiro paciente, um homem de 27 anos, foi diagnosticado com infecção pelo vírus da dengue e desenvolveu síndrome nefrótica após duas semanas de doença. Ele foi tratado com metilprednisolona por três dias e furosemida endovenosa. O paciente evoluiu bem, embora sua função renal não tenha se recuperado plenamente. O segundo paciente, um homem de 32 anos, foi diagnosticado com apresentação clínica mais discreta de infecção pelo vírus da dengue. Ele tinha histórico de síndrome nefrótica na infância, o que pode ter causado a recidiva. O paciente foi tratado com furosemida endovenosa e também não recuperou plenamente sua função renal. Os dois casos destacam a possível implicação da infecção pelo vírus da dengue na etiologia da variante colapsante da GESF. Os profissionais de saúde devem estar preparados para identificar casos semelhantes.

Co-infection of SARS-CoV-2 and dengue virus: a clinical challenge

Abstract Many regions of the world where dengue epidemics are seasonal are also facing the COVID-19 pandemic. This is a medical concern because both diseases are difficult to distinguish since they have similar clinical symptoms and laboratory findings, and because they have different clinical management. So far, co-infection of SARS-CoV-2 and dengue virus (DENV) has not been studied. Herein we report the first case of a patient with co-infection of COVID-19 and dengue. Both infections were simultaneously laboratory confirmed by positive RT-qPCR for SARS-CoV-2 and RT-qPCR for DENV, NS1, IgM and IgG antibody tests for dengue. The patient had a favorable clinical improvement, without severe symptoms. This case emphasize that, in pandemic era, having a diagnostic of one infection does not rule out the possibility of having another infection concomitantly. In addition, underscores the importance of an accurate and timely diagnosis to prevent the spread of COVID-19.

Manifestaciones inusuales en enfermedad por dengue en pediatría. ¿Olvidadas o infrecuentes? / Unusual manifestations in pediatric dengue disease. ¿Forgotten or infrequent?

Introducción: El dengue representa un importante problema de salud pública en países como Colombia. Usualmente se trata de una patología autolimitada con buena respuesta a manejo sintomático ambulatorio, sin embargo, cuadros con síntomas atípicos pueden complicar el diagnóstico dando lugar a manifestaciones inusuales que comprometen la vida del paciente. Objetivo: Describir la información del tema expuesto resaltando aspectos relevantes como diagnóstico y manejo. Metodología: Se efectuó una revisión bibliográfica con búsqueda electrónica en las siguientes bases de datos: PubMed, MEDLINE, Medscape, Scopus; en inglés y español incluyéndose diferentes tipos de artículo (artículos originales, revisiones de temas y guías de manejo que abordaran síntomas inusuales de dengue en pediatría desde el año 2009 al 2019. Resultados: Se obtuvo 414 referencias después de una revisión de artículos, donde se describe el tema de complicaciones relacionadas con esta patología en pediatría, se seleccionaron 50 artículos en texto completo que cumplían los requisitos de búsqueda. Conclusiones: El tema de manifestaciones atípicas del dengue tiene poca revisión registrada en el área de pediatría, son complicaciones poco frecuentes por lo cual la evidencia es escasa, estas se deben tener en cuenta para manejo y tratamiento oportuno.

Introduction: Dengue represents a major public health problem in countries like Colombia. Usually it is a self-limited pathology with good response to outpatient symptomatic management, however, pictures with atypical symptoms can complicate the diagnosis resulting in unusual manifestations that compromise the patient's life. Objective: Describe the information on the exposed topic highlighting relevant aspects such as diagnosis and management. Methodology: A bibliographic review was carried out with electronic search in the following databases: PubMed, MEDLINE, Medscape, Scopus; in English and Spanish including different types of article (original articles, review of topics and management guides that will address unusual symptoms of dengue in pediatrics from 2009 to 2019. Results: 414 references were obtained after an article review, which describes the topic of complications related to this pathology in pediatrics, 50 articles were selected in full text that met the search requirements. Conclusions: The issue of atypical manifestations of dengue has little revision registered in the area of pediatrics, they are rare complications, so the evidence is scarce, these should be taken into account for timely management and treatment.