Multisystem Failure in Fatal Dengue: Associations between the Infectious Viral Serotype and Clinical and...

Area of Science:

• Virology
• Pathology
• Epidemiology

Background:

• Dengue is a major global arthropod-borne viral infection.
• The viral pathogenesis of dengue remains poorly understood.
• Fatal dengue cases offer critical insights into host-pathogen interactions.

Purpose of the Study:

• To investigate associations between clinical features, histopathology, and viral characteristics in fatal dengue cases.
• To understand the tissue tropism and replication of dengue virus serotypes in lethal infections.

Main Methods:

• Analysis of clinical data and histopathological findings from dengue fatalities.
• Detection of viral antigen localization and infecting serotype using immunohistochemistry and real-time PCR.
• Assessment of viral replication in affected tissues.

Main Results:

• Fatal dengue cases predominantly affected individuals under 20.
• Common clinical signs included bleeding, abdominal pain, myalgia, and headache.
• Multiorgan pathology was observed, particularly in the liver, spleen, and lungs, where viral antigens were concentrated.
• No significant associations were found between histopathological changes, viral location, serotype, and replication levels.

Conclusions:

• Dengue should be recognized as a systemic, multiorgan disease.
• The clinical outcome in fatal dengue cases may not be directly linked to the specific infecting dengue virus serotype or its replication patterns.