Acute Fever Early Post Renal Transplantation-A Call From the Tropics

Infection with Dengue virus (DENV)is a growing concern in solid organ transplant (SOT) recipients in endemic regions. We report a 15-year-old kidney transplant recipient who developed fever and thrombocytopenia on post-transplant day five; DENV NS1 antigen confirmed acute infection. He recovered with supportive care, and no donor-derived transmission was identified. A review of 327 cases shows early post-transplant dengue carries higher risks of cytopenias, capillary leak, graft dysfunction, and mortality (6.1%) versus the general population. Improved diagnostics, outbreak-responsive donor screening, and pre-transplant vaccination in immunocompetent candidates may help mitigate dengue burden in SOT recipients.