Infección por dengue sin signos de alarma en un niño con cardiopatía chagásica crónica / Dengue infection in a child with chronic heart disease for Chagas

Se presenta el caso de un preescolar en que se diagnosticó una cardiomiopatía chagásica crónica posterior a una infección aguda por virus dengue. El niño, residente de un área endémica para enfermedad de Chagas, debutó con insuficiencia cardíaca que mejoró con el tratamiento de soporte y tras la resolución completa de la arbovirosis, persistieron los cambios de cardiomiopatía crónica. Esta evidencia de alteración estructural miocárdica se atribuyó a la cardiomiopatía chagásica de base previamente subclínica. La coexistencia de enfermedades infecciosas en el trópico representa un reto diagnóstico, situación a la que se agregan problemas socioeconómicos como la pobreza y falta de acceso a servicios sanitarios básicos.

A case is reported of a chronic chagasic cardiomyopathy in a two-years old child who was diagnosed after an acute dengue virus infection. The patient residing in an endemic area for Chagas disease, debuted with heart failure that improved with support treatment and after the complete resolution of the arbovirus, the changes of chronic cardiomyopathy persisted. The myocardial structural alteration was attributed to subclinical chagasic cardiomyopathy. The coexistence of infectious diseases in the tropics represents a diagnostic challenge, a situation to which are added problems such as poverty and lack of access to basic health services.

Ultrasound image of Dengue hemorrhagic fever`

Ultrasound cross-sectional prospective investigation on 16 patients with Dengue fever, showed that 15/16 cases, gall bladder wall thickness was a factor of prognosis, standard for patients with high risk of volume dropping shock related to kidney syndrome, 12/16 cases with abdominal cavity fluid, 7/16 cases there was perirenal collection of fluid, 3/16 cases of fluid subcapsular collection in the liver, pleural effusion. In addition, there may be large pancreas and spontaneous rupture of the kidney.