{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T09:30:04Z","timestamp":1786959004516,"version":"build-2736575974"},"reference-count":45,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:00:00Z","timestamp":1786752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin. Pract.","Clinics and Practice"],"abstract":"<jats:p>Background\/Objectives: Severe dengue and dengue\u2013malaria coinfection represent major diagnostic and therapeutic challenges in tropical endemic settings, where overlapping clinical manifestations may delay recognition of deterioration. This study aimed to describe the clinical and epidemiological characteristics of patients with severe dengue, dengue with warning signs, and dengue\u2013malaria coinfection treated at a referral hospital in Monter\u00eda, C\u00f3rdoba, Colombia. Methods: A retrospective case series was conducted by reviewing medical records of patients diagnosed with dengue between 2018 and 2023. Cases classified as dengue without warning signs were excluded. The final analysis included patients with dengue-warning signs, severe dengue, and dengue\u2013malaria coinfection. Dengue classification followed the 2009 World Health Organization criteria, and malaria was confirmed by thick blood smear. Sociodemographic, clinical, laboratory, geographic, and outcome-related variables were collected. Descriptive analyses were performed, and selected categorical variables were compared using Fisher\u2019s exact test. Results: Fifty-three patients were included: 25 (47.17%) with severe dengue, 14 (26.42%) with dengue with warning signs, and 14 (26.42%) with dengue\u2013malaria coinfection. Severe dengue was more frequent among females, whereas dengue with warning signs and coinfection predominated in males. Children accounted for the highest proportion of severe dengue cases, while coinfected cases were mainly distributed between childhood and adolescence. Fever was documented in all patients. Edema, elevated hematocrit, severe plasma leakage, and hemodynamic compromise were more frequent among severe dengue cases, whereas myalgia differed significantly across clinical groups. Ten deaths were recorded, six occurring in coinfected patients. Conclusions: Severe dengue and dengue\u2013malaria coinfection are clinically complex conditions with overlapping manifestations and potentially fatal outcomes, highlighting the need for early recognition, differential diagnosis, and close monitoring.<\/jats:p>","DOI":"10.3390\/clinpract16080150","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T08:05:41Z","timestamp":1786953941000},"page":"150","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Dengue and Dengue\u2013Malaria Coinfection: A Case Series from a Referral Hospital in Monter\u00eda, Colombia"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8739-7247","authenticated-orcid":false,"given":"Paula A.","family":"Avil\u00e9s-Vergara","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sin\u00fa El\u00edas Bechara Zain\u00fam, Monter\u00eda 230001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2471-1347","authenticated-orcid":false,"given":"Dina","family":"Ricardo-Caldera","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Enfermedades Tropicales y Resistencia Bacteriana, Facultad de Ciencias de la Salud, Universidad del Sin\u00fa El\u00edas Bechara Zain\u00fam, Monter\u00eda 230001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9425-9475","authenticated-orcid":false,"given":"Osnamir Elias","family":"Bru-Cordero","sequence":"additional","affiliation":[{"name":"Direcci\u00f3n Acad\u00e9mica, Universidad Nacional de Colombia, Sede de La Paz, Kil\u00f3metro 9 V\u00eda Valledupar-La Paz, Valledupar 202017, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Alberto","family":"Miranda","sequence":"additional","affiliation":[{"name":"Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Sin\u00fa El\u00edas Bechara Zain\u00fam, Monter\u00eda 230001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angie Paola","family":"Mart\u00ednez Villera","sequence":"additional","affiliation":[{"name":"Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Sin\u00fa El\u00edas Bechara Zain\u00fam, Monter\u00eda 230001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Alexander","family":"Angulo \u00c1lvarez","sequence":"additional","affiliation":[{"name":"Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Sin\u00fa El\u00edas Bechara Zain\u00fam, Monter\u00eda 230001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Carolina","family":"Geney Caro","sequence":"additional","affiliation":[{"name":"Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Sin\u00fa El\u00edas Bechara Zain\u00fam, Monter\u00eda 230001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,15]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, April 18). 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