{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:42:45Z","timestamp":1790376165004,"version":"4.1.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T00:00:00Z","timestamp":1648512000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T00:00:00Z","timestamp":1648512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Dengue is a mosquito-borne viral infection that typically occurs in tropical and subtropical countries. The clinical manifestations of dengue infection range from an asymptomatic subclinical course to severe dengue shock syndrome. Besides, dengue can affect any organ in the body and can present with atypical manifestations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report a 6-year-old previously healthy Tamil child who had dengue complicated with multiorgan involvement. She initially presented with high fever, headache, body aches for 5\u00a0days, blood and mucus diarrhea, hematuria, and right knee joint swelling for 2 days. Dengue NS1 antigen was positive on day 2 of febrile illness. She was managed symptomatically in the local hospital for 3\u00a0days and transferred to the tertiary care hospital for further management. She was eventually diagnosed as having dengue hemorrhagic fever complicated with multiorgan involvement including acute liver failure, pancreatic involvement, coagulopathy, arthritis, acute kidney injury, and multiple intracranial hemorrhages. The constellation of disease manifestations was identified as expanded dengue syndrome. She was managed with fresh blood, platelet, and cryoprecipitate transfusions and intravenous antibiotics in addition to renal and liver support in the intensive care unit. On day 14 of illness, she deteriorated while on the ventilator and died due to multiple intracranial hemorrhages.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The reported child with dengue hemorrhagic fever developed several unusual presentations such as acute liver and renal failure, disseminated intravascular coagulopathy, pancreatic involvement, and multiple intracranial hemorrhages, which form part of expanded dengue syndrome. In the seriously unwell child, it is important to look for unusual complications actively to improve outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-022-03348-0","type":"journal-article","created":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T23:04:02Z","timestamp":1648508642000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Expanded dengue syndrome presenting with acute liver failure, acute kidney injury, pancreatic involvement, coagulopathy, and multiple intracranial hemorrhages in a young child: a case report"],"prefix":"10.1186","volume":"16","author":[{"given":"V.","family":"Thadchanamoorthy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavinda","family":"Dayasiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,29]]},"reference":[{"issue":"3","key":"3348_CR1","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1128\/CMR.11.3.480","volume":"11","author":"DJ Gubler","year":"1998","unstructured":"Gubler DJ. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev. 1998;11(3):480\u201396.","journal-title":"Clin Microbiol Rev"},{"key":"3348_CR2","first-page":"53","volume":"22","author":"TA Kulatilaka","year":"1998","unstructured":"Kulatilaka TA, Jayakuru WS. Control of dengue\/dengue haemorrhagic fever in Sri Lanka. Dengue Bull. 1998;22:53\u201361.","journal-title":"Dengue Bull"},{"key":"3348_CR3","unstructured":"Epidemiology Unit, Ministry of Health, Sri Lanka. Distribution of notification (H399) dengue cases by month. http:\/\/www.epid.gov.lk\/web\/index.php?option=com_casesanddeaths&Itemid=448&lang=en#. Accessed 15 May 2018."},{"issue":"4","key":"3348_CR4","doi-asserted-by":"publisher","first-page":"682","DOI":"10.3201\/eid2604.190435","volume":"26","author":"HA Tissera","year":"2020","unstructured":"Tissera HA, Jayamanne BDW, Raut R, et al. Severe dengue epidemic, Sri Lanka, 2017. Emerg Infect Dis. 2020;26(4):682\u201391. https:\/\/doi.org\/10.3201\/eid2604.190435.","journal-title":"Emerg Infect Dis"},{"key":"3348_CR5","unstructured":"World health organization. Fact sheet: dengue and severe dengue. https:\/\/www.who.int\/newsroom\/fact-sheets\/detail\/dengue-and-severe-dengue."},{"key":"3348_CR6","unstructured":"World Health organization Comprehensive guidelines for prevention and treatment of dengue and dengue hemorrhagic fever. New Delhi: WHO, SEARO; revised and expanded edition."},{"issue":"3","key":"3348_CR7","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.4103\/jfmpc.jfmpc_12_19","volume":"8","author":"B Mohanty","year":"2019","unstructured":"Mohanty B, Sunder A, Pathak S. Clinicolaboratory profile of expanded dengue syndrome\u2014our experience in a teaching hospital. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there is no conflict of interests regarding the publication of this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"123"}}