OBJECTIVE

To determine whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) within the first three days of dengue illness are independent predictors of dengue severity among pediatric patients.

METHODOLOGY

A cross-sectional analytical retrospective study was conducted among pediatric dengue patients admitted to The Medical City, Pasig from September 2021 to August 2024. Data collection was done through electronic chart review. Baseline characteristics were analyzed using the Kruskal-Wallis test, Chi-Square test, and Fisher’s exact test. Receiver Operating Characteristic (ROC) and Area Under the Curve (AUC) analyses, along with diagnostic performance metrics, were used to evaluate daily ratio cut-offs differentiating dengue classifications. Multivariable logistic regression was performed to assess NLR and PLR as independent predictors of warning signs or severe dengue development.

RESULTS

Among the 316 subjects included in the analysis, 40.5% had dengue fever without warning signs, 57.3% had dengue fever with warning signs, and 2.2% had severe dengue. Differentiating patients without warning signs from those with warning signs, the NLR cut-offs were 4.73, 2.07, and 2.5 on days 1-3, respectively, whereas from those with severe dengue, the cut-offs were 1.27, 0.68, and 0.47 on the same days. For this pairwise analysis, PLR cut-offs were 170, 233.92, and 208.79 for the first comparison; and 209.24, 244.12, and 187.5 for the second, respectively. Statistical analysis showed poor discrimination and diagnostic performance for all cut-offs. Likewise, multivariable linear regression revealed no significant correlation between either ratio and dengue severity.

CONCLUSION

NLR and PLR within the first three days of dengue illness revealed poor performance in predicting the development of warning signs or progression to severe dengue among pediatric patients.

Human ; Dengue Fever ; Dengue

OBJECTIVE

To describe a case of dengue-associated bilateral neuroretinitis in a young female adult.

METHODS

This is a case report.

RESULTS

A 25-year-old female was referred for evaluation of bilateral blurring of vision during the convalescent stage of dengue fever. Visual acuity was 20/80 in each eye. Fundoscopy showed mild optic disc swelling, macular thickening, and hard exudates bilaterally. Dengue-associated neuroretinitis was considered. Intravenous methylprednisolone treatment for three days resulted in significant improvements in visual function and resolution of fundus abnormalities.

CONCLUSION

Dengue is a potential etiology of neuroretinitis in endemic areas, especially in those who develop visual symptoms during the convalescent phase. Prompt recognition and treatment may prevent long-term visual impairment.

Human ; Female ; Adult: 25-44 Yrs Old ; Dengue Fever ; Dengue ; Neuroretinitis ; Retinitis ; Methylprednisolone

Mosquito-borne viruses, including dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV), pose major threats to public health in tropical and subtropical regions worldwide. Neonates are particularly vulnerable, and the associated disease burden has drawn increasing attention. Routes of neonatal infection include vertical mother-to-child transmission (transplacental and peripartum) and postnatal mosquito bites. Clinical manifestations are often nonspecific; a proportion of cases may progress to central nervous system infection, hemorrhagic disease, or long-term neurodevelopmental impairment, with serious consequences for survival and quality of life. Although China has issued prevention and control guidelines for adults and pregnant women, systematic clinical guidance tailored to neonates remains lacking. In response, the Perinatal Group of the Pediatric Branch of the Chinese Medical Doctor Association convened a multidisciplinary panel to develop this expert consensus, integrating the latest international evidence with China's practical prevention and control experience. The consensus addresses epidemiology; the effects of maternal infection on fetuses and neonates; clinical manifestations; diagnosis and differential diagnosis; early warning indicators of severe disease; therapeutic strategies and supportive care; and prevention and maternal-infant management. It aims to provide evidence-based, standardized, and practical guidance for frontline clinicians managing neonatal mosquito-borne viral infections.
Humans ; Zika Virus Infection/therapy* ; Infant, Newborn ; Chikungunya Fever/therapy* ; Dengue/prevention & control* ; Female ; Pregnancy ; Consensus

OBJECTIVE

To present the case of a 17-year-old girl who was readmitted post-tonsillectomy due to dengue fever, hematemesis and late tonsillar bleeding three weeks after the surgery.

METHODS

Design:Case Report

Setting:Tertiary Government Training Hospital

Patient: One

RESULTS

A previously healthy 17-year-old Filipino girl underwent uncomplicated elective tonsillectomy for chronic hypertrophic tonsillitis. Twenty days post-operatively, she developed fever, thrombocytopenia and massive hematemesis. Despite intensive care management for severe dengue fever with concurrent late post-tonsillectomy bleeding, the patient died from hemorrhagic shock on post-operative day 21.

CONCLUSION

This appears to be the first reported case of concurrent late post-tonsillectomy hemorrhage and dengue fever in a previously healthy adolescent girl. In dengue-endemic areas, post-tonsillectomy patients should be counseled about dengue prevention and advised to seek medical attention for persistent fever. Early recognition and management of this potentially fatal combination is crucial for improving patient outcomes.

Human ; Female ; Adolescent: 13-18 Yrs Old ; Tonsillectomy ; Mortality ; Dengue ; Severe Dengue ; Dengue Hemorrhagic Fever

Dengue hemorrhagic fever is a severe form of dengue presenting commonly with bleeding diathesis, but rarely with peripheral nervous system manifestations. Proximal median neuropathy comprises 1% of upper limb compression syndromes, and this case is the first to report injury to the proximal median nerve due to compression from hematoma formation. This case report presents the rehabilitation process of a 25-year-old Filipino female median nerve entrapment from venipuncture-associated hematoma presenting as burning sensation on the medial elbow, forearm and hand, weak flexion movement of her left thumb, index, and middle fingers. The patient was managed conservatively with pain medications, range of motion, gross and fine motor, and sensory re-education exercises. At 12 months, there was partial but functional recovery of median motor distribution and full recovery of median sensory distribution, as evidenced by improved sensory nerve action potential conduction velocity and amplitude, and compound motor action potential conduction velocity, with persistent decreased amplitude at 50%, and decrease in cross-sectional area of the left median nerve.

This paper highlights the functional outcomes of a conservatively managed median nerve entrapment from venipuncture hematoma from dengue hemorrhagic fever. This case report also emphasizes that in the presence of severe bleeding risk of surgery in the background of severe thrombocytopenia, timely rehabilitation medicine referral with monitoring through clinical evaluation, musculoskeletal ultrasound, and electrodiagnostic study presents a viable alternative in the management of compression neuropathy.

Dengue Hemorrhagic Fever ; Severe Dengue ; Nerve Conduction Studies ; Rehabilitation

Dengue fever infection is common in many parts of the world and may result in serious complications such as dengue haemorrhagic fever, dengue shock syndrome, pleural effusion, pericardial effusion and multi-organ failure if not diagnosed early or treated adequately. This is more so in the so called susceptible group that includes children, pregnant mother, elderly patients, patients with heart, liver or kidney co-morbidity, obese patients as well as immunocompromised patient such as those with transplanted organs or human immune-deficiency infection. However in certain cases, severe dengue fever may mimic the presentation of septic shock which needs urgent and decisive management actions to be taken. This case report will look at a 7-year-old child who survived despite developing septic shock which was thought to be initially dengue fever with warning signs. Early referral and aggressive treatment in hospital prevented a direr consequence for this child.
Dengue fever

A rapid diagnostic test (RDT) kit was developed to detect non-structural protein 1 (NS1) of yellow fever virus (YFV) using monoclonal antibody. NS1 protein was purified from the cultured YFV and used to immunize mice. Monoclonal antibody to NS1 was selected and conjugated with colloidal gold to produce the YFV NS1 RDT kit. The YFV RDTs were evaluated for sensitivity and specificity using positive and negative samples of monkeys from Brazil and negative human blood samples from Korea. Among monoclonal antibodies, clones 3A11 and 3B7 proved most sensitive, and used for YFV RDT kit. Diagnostic accuracy of YFV RDT was fairly high; Sensitivity was 0.0% and specificity was 100% against Dengue viruses type 2 and 3, Zika, Chikungunya and Mayaro viruses. This YFV RDT kit could be employed as a test of choice for point-of-care diagnosis and large scale surveys of YFV infection under clinical or field conditions in endemic areas and on the globe.
Animals ; Antibodies, Monoclonal ; Brazil ; Clone Cells ; Dengue Virus ; Diagnosis ; Diagnostic Tests, Routine ; Gold Colloid ; Haplorhini ; Humans ; Korea ; Mice ; Point-of-Care Systems ; Sensitivity and Specificity ; Yellow fever virus ; Yellow Fever

INTRODUCTION: Typhoon Haiyan, or Typhoon "Yolanda" in the Philippines, caused catastrophic damage last November 8, 2013 in the islands of Leyte. As of April 17, 201, NDRRMC confirmed 6,300 fatalities across the country and around 5,877 were from Eastern Visayas. The actual death toll remained unclear although it is being claimed to be about 10,000 in Tacloban City alone.

OBJECTIVE: This study aimed to determine the transmission of notifiable diseases under PIDSR as to increase in morbidity, deaths and case fatality rates among patients consulted and/or admitted at EVRMC before and after ST Yolanda.

MATERIALS AND METHODS: This is a descriptive study which included all patients who sought consultation and/or admission in EVRMC with clinical diagnosis of any notifiable disease under the PIDSR reference list.

RESULTS: A cumulative total of 8,299 patients with notifiable diseases sought and/or admission between November 2012 - October 2013 and November 2013 - October 2014. Of which, 3,873 or 46.67% were cases before Super Typhoon Yolanda while 4,426 or 53.33% were cases a year after. Patients below 14 years old were mostly affected after the disaster. There were few patients, 70 years old and above who sought consultation and/or admission. As to occurrence between sexes, there were more females affected than males after the disaster which comprised of 51.4% of the total. As to geographic distribution, there were more cases coming from the 1st district of Leyte including Tacloban City comprising 61.58% compared to its occurrence prior to the disaster.  As to the number of cases under Category I, an increased cases of measles from 2 cases to 356 or an increase of 99.44% after the disaster. Notifiable diseases under Category II comprised 91.53% of the total post disaster with an increase of 12.5% from the total cases the previous year. Acute watery diarrhea had the highest number of patients affected then, was followed by Dengue fever,  27.43% and Acute bloody diarrhea, 2.35%. Chikungunya increased from 10 cases the previous year to 33. As to deaths, there was no increase under Category I but, under Category II, an increase of 26.1% after the typhoon was observed. Among these, were Acute watery diarrhea, Dengue fever, Influenza like illness and Measles after disaster.

CONCLUSION: During calamities, everything is affected, from infrastructure, agriculture and most of all the people. Transmission of different infectious diseases occur because of displacement of the population, lack of safe water supply and sanitation facilities and, lack of available health care services.

Human ; Male ; Female ; Cyclonic Storms ; Sanitation ; Philippines ; Influenza, Human ; Disasters ; Chikungunya Fever ; Cities ; Measles ; Dengue ; Water Supply ; Diarrhea ; Agriculture ; Islands

PURPOSE: The number of dengue fever cases is rising due to increasing overseas travel. Vaccination makes severe dengue fever in seronegative individuals after vaccination when they exposure to wild-type dengue virus. We investigated the seroepidemiology of the dengue virus for monitoring of Korean dengue virus immunity and establishing the prevention of dengue infection. METHODS: The study was based on 446 residual sera collected from 98 infants (2 months to 1 year old), 152 adolescents (13 to 19 years old), 90 adults (20 to 50 years old), and 106 elderly participants (more than 65 years old) for other studies. Antibody levels for dengue virus immunoglobulin G (IgG) in each age group were measured using an enzyme-linked immunosorbent assay (ELISA). For each dengue virus IgG positive or equivocal result, an IgG ELISA was performed for Japanese encephalitis virus. RESULTS: Of the 446 serum samples, only 1 (0.2%) adolescent had a positive result from the dengue IgG antibody test. In the dengue virus IgG antibody test, 14 (3.1%) samples showed equivocal results (10 adolescents and 4 elderly). In the 1 positive case of dengue virus IgG, the Japanese encephalitis IgG test was also positive. In the 14 equivocal cases of dengue virus IgG, there were 6 positive, 3 equivocal, and 5 negative of Japanese encephalitis IgG. CONCLUSIONS: The seroprevalence rate of dengue virus was very low in Koreans. This study provides important data for establishing the policy for preventive measures of dengue fever. It will be necessary to continuously monitor for dengue virus immunity.
Adolescent ; Adult ; Aged ; Dengue Virus ; Dengue ; Encephalitis Virus, Japanese ; Encephalitis, Japanese ; Enzyme-Linked Immunosorbent Assay ; Fever ; Humans ; Immunoglobulin G ; Infant ; Korea ; Prevalence ; Seroepidemiologic Studies ; Severe Dengue ; Vaccination

We developed a Rapid Diagnostic Test (RDT) kit for detecting IgG/IgM antibodies against Zika virus (ZIKV) using monoclonal antibodies to the envelope (E) and non-structural protein 1 (NS1) of ZIKV. These proteins were produced using baculovirus expression vector with Sf9 cells. Monoclonal antibodies J2G7 to NS1 and J5E1 to E protein were selected and conjugated with colloidal gold to produce the Zika IgG/IgM RDT kit (Zika RDT). Comparisons with ELISA, plaque reduction neutralization test (PRNT), and PCR were done to investigate the analytical sensitivity of Zika RDT, which resulted in 100% identical results. Sensitivity and specificity of Zika RDT in a field test was determined using positive and negative samples from Brazil and Korea. The diagnostic accuracy of Zika RDT was fairly high; sensitivity and specificity for IgG was 99.0 and 99.3%, respectively, while for IgM it was 96.7 and 98.7%, respectively. Cross reaction with dengue virus was evaluated using anti-Dengue Mixed Titer Performance Panel (PVD201), in which the Zika RDT showed cross-reactions with DENV in 16.7% and 5.6% in IgG and IgM, respectively. Cross reactions were not observed with West Nile, yellow fever, and hepatitis C virus infected sera. Zika RDT kit is very simple to use, rapid to assay, and very sensitive, and highly specific. Therefore, it would serve as a choice of method for point-of-care diagnosis and large scale surveys of ZIKV infection under clinical or field conditions worldwide in endemic areas.
Antibodies ; Antibodies, Monoclonal ; Baculoviridae ; Brazil ; Cross Reactions ; Dengue Virus ; Diagnosis ; Diagnostic Tests, Routine ; Enzyme-Linked Immunosorbent Assay ; Flavivirus ; Gold Colloid ; Hepacivirus ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Methods ; Neutralization Tests ; Point-of-Care Systems ; Polymerase Chain Reaction ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Sf9 Cells ; Yellow Fever ; Zika Virus