Fulminant hepatitis secondary to dengue in pediatric patients: a series of four cases

Related Experiment Video

Updated: May 12, 2026

Measuring Dengue Virus RNA in the Culture Supernatant of Infected Cells by Real-time Quantitative Polymerase Chain Reaction
08:36

Measuring Dengue Virus RNA in the Culture Supernatant of Infected Cells by Real-time Quantitative Polymerase Chain Reaction

Published on: November 1, 2018

Isabelly Victoria Simões Melchiori1, Mariana Favero Elias1, Jhonny Richard de Sousa1

  • 1Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.

Revista Do Instituto De Medicina Tropical De Sao Paulo
|February 19, 2026
PubMed

Insights

Dengue can cause severe liver failure in children, sometimes requiring liver transplants. Early recognition of dengue complications is crucial for better outcomes, especially in children with underlying health conditions.

Area of Science:

  • Pediatric Hepatology
  • Infectious Diseases
  • Transplantation Medicine

Background:

  • Dengue virus infection is a significant global health concern, particularly in tropical and subtropical regions.
  • Fulminant hepatitis and acute liver failure are rare but severe complications of dengue, especially in pediatric populations.
  • Limited data exists on dengue-associated fulminant hepatitis in children, necessitating further investigation into diagnosis and management.

Purpose of the Study:

  • To report a case series of pediatric patients with dengue who developed fulminant hepatitis and acute liver failure.
  • To emphasize the importance of early recognition of dengue-related complications, particularly fulminant hepatitis.
  • To review and contextualize these cases with existing literature on dengue-associated fulminant hepatitis in children.

Main Methods:

  • A case series of four pediatric patients with dengue-induced fulminant hepatitis was compiled.
  • A comprehensive literature review was conducted to analyze prior reports on dengue-associated fulminant hepatitis in children.
  • Clinical courses, diagnostic approaches, and management strategies, including liver transplantation, were examined.

Main Results:

  • Four pediatric patients (two girls, two boys) presented with dengue and developed fulminant hepatitis requiring liver transplantation.
  • Outcomes varied: two patients had favorable postoperative courses, while two with hemoglobinopathies (SC disease, sickle cell anemia) died post-transplant.
  • The severity of dengue-induced liver failure and post-transplant outcomes were influenced by patient age and comorbidities.

Conclusions:

  • Dengue can precipitate fulminant hepatitis and acute liver failure in children, even those previously healthy.
  • Comorbidities, such as hemoglobinopathies, may be associated with poorer outcomes in pediatric dengue patients with liver failure.
  • Prompt recognition of severe dengue manifestations is critical for timely intervention and optimizing management, including liver transplantation decisions.

More Related Videos

A Murine Model of Dengue Virus-induced Acute Viral Encephalitis-like Disease04:23

A Murine Model of Dengue Virus-induced Acute Viral Encephalitis-like Disease

Published on: April 28, 2019

Portable Paper-Based Immunoassay Combined with Smartphone Application for Colorimetric and Quantitative Detection of Dengue NS1 Antigen06:00

Portable Paper-Based Immunoassay Combined with Smartphone Application for Colorimetric and Quantitative Detection of Dengue NS1 Antigen

Published on: January 26, 2024

Related Concept Videos

Diphtheria01:28

Diphtheria

Diphtheria is an acute, toxin-mediated infectious disease that primarily affects the upper respiratory tract. It is caused by Corynebacterium diphtheriae, a Gram-positive, pleomorphic rod that lacks spore-forming capability and exhibits a characteristic club-shaped morphology under microscopic examination. While C. diphtheriae can asymptomatically colonize mucosal surfaces, clinical disease manifests only when the bacterial strain is lysogenized by a specific β-corynephage. This phage...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
Hepatitis01:25

Hepatitis

Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver. The...
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion of food...