Successful Management of Severe Dengue with Hepatitis and Shock in an 8-Year-Old Child

An 8-year-old male child, Rana, was brought to the hospital with severe vomiting, high-grade fever, dehydration, and features of shock. On arrival, the child was critically ill and required immediate emergency intervention.

Initial Management

The child was promptly resuscitated. Shock was corrected using two boluses of normal saline, following which inotropic support was initiated to stabilise circulation. Continuous monitoring was ensured in a high-dependency setting.

Diagnostic Findings

Comprehensive blood investigations revealed:

These findings indicated a severe and complicated form of dengue, requiring aggressive and multidisciplinary management.

Treatment Approach

The child was managed with:

Given the severity of hepatic involvement and coagulation abnormalities, plasmapheresis was performed as a life-saving therapeutic intervention.

Outcome

Following plasmapheresis and continued supportive care, the child showed remarkable clinical improvement. Vital parameters stabilised, liver function tests and coagulation profile gradually improved, and inotropic support was tapered successfully.

After 7 days of hospitalisation, the child recovered fully and was discharged in a healthy and stable condition.

Expert Insight

According to Dr. S. L. Narasimha Reddy, Neonatologist, Kondapur, early recognition of shock, timely correction of dehydration, and advanced supportive therapies like plasmapheresis play a crucial role in managing severe dengue cases with multi-organ involvement in children.

Conclusion

This case highlights the importance of early diagnosis, rapid resuscitation, advanced critical care, and timely intervention in saving children with severe dengue complications. With a structured, multidisciplinary approach, even critically ill pediatric patients can achieve excellent outcomes.