Journal of Pediatric Research and Neonatal Care

An Uncommon Presentation: Acute Necrotizing Pancreatitis as an Initial Manifestation of Dengue Hemorrhagic Fever in a Pediatric Patient

Mahaveer Singh Lakra*

Senior resident, Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, India

Abstract

Background: Dengue fever, a prevalent acute viral infection in developing countries, exhibits a spectrum of presentations in children, ranging from mild cases to severe complications. Acute necrotizing pancreatitis, an uncommon and serious form of pancreatitis, is rarely observed in pediatric cases. This article presents a unique case involving the unusual presentation of acute necrotizing pancreatitis as the initial manifestation of dengue fever.

Case Details: A 15-year-old male child presented with abdominal pain, distension, and vomiting, along with a month-long history of intermittent fever. Abdominal examination revealed ascites and hepatomegaly. Positive results for Dengue NS1 antigen and dengue serology IgM were obtained. Serum amylase and lipase levels were elevated at 1540 U/L and 960 U/L, respectively. Contrast-enhanced CT scan and MRCP demonstrated a voluminous pancreas with decreased enhancement and the presence of ascites. The patient received conservative management, including intravenous fluids, antibiotics, and octreotide, leading to a successful discharge. To the best of my knowledge, the presentation of acute necrotizing pancreatitis as an initial feature of dengue fever in children has not been previously reported.

Conclusion: Dengue fever can manifest with diverse clinical presentations, and when a patient presents with abdominal pain, vomiting, and fever, clinicians should consider the possibility of acute pancreatitis. Maintaining a high clinical suspicion is crucial, and timely intervention can contribute to complete recovery and favorable outcomes.

Keywords:

Necrotizing pancreatitis; Dengue fever; Ascites; Serum Amylase; Octreotide