Pune: 10-yr-old with rare paediatric co-infection of dengue and Covid treated successfully

Arya (name changed) was brought to the hospital’s flu clinic with complaints of high grade fever (102 degrees Fahrenheit every eight to 12 hours), along with a sore throat, malaise, and nausea since five days, as well as a Covid-19 positive RT PCR report.

Aditya Birla Memorial Hospital successfully treated a 10-year-old girl, who had a rare case of paediatric co-infection of dengue and coronavirus.

Arya (name changed) was brought to the hospital’s flu clinic with complaints of high grade fever (102 degrees Fahrenheit every eight to 12 hours), along with a sore throat, malaise, and nausea since five days, as well as a Covid-19 positive RT PCR report. There were no complaints of cough and breathlessness. All family members had tested positive for Covid-19 as well – Arya’s father with mild symptoms, and the rest being asymptomatic.

On being examined at Aditya Birla Flu Clinic, her initial physical examination revealed a temperature of 103 F, with tachycardia, which is a condition that makes one’s heart beat more than 100 times per minute. While there was no respiratory distress, with her oxygen saturation (spO2) levels being 98 per cent on room air, she had co-morbid conditions of being overweight (BMI – 25.6). Her outside reports suggested leukopenia, a condition where the number of white cells reduces in the blood, and her chest X-ray report showed bilateral infiltrates.

On being admitted in the isolation ward and beginning her treatment, Arya’s laboratory tests were conducted and the initial screening reported worsening of leukopenia, with normal platelets, deranged liver enzymes and raised inflammatory markers. She was started on medications and underwent HRCT chest.

However, on the second day of her admission, she developed erythematous maculopapular rash (abnormal redness and rash of both flat and raised lesion) on her torso and extremities. On repeating lab tests, it was revealed that her WBC and platelet count had further reduced. “We conducted tests for NS1 and anti-IgM dengue, and the results came back positive,” Dr Vrushali Bichkar, associate consultant neonatologist and paediatrician said.

“According to current literature knowledge, this is among the first few cases of co-infection of Covid-19 and dengue reported in paediatric population till date,” Dr Rahul Kallianpur, associate director, Department of Neonatology and Paediatrics, said. “It is important for paediatricians and treating physicians to be increasingly aware of this emerging phenomena of co-infection going forward as cases of dengue start to peak amid a pandemic at its peak.”

The child was closely monitored and treated, and repeat Covid RT PCR tests came back negative. Repeat blood samples for dengue showed primary dengue infection. Arya’s WBC and platelet count normalised as well, and she was discharged on oral vitamins in a healthy condition.

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