Dengue Fever in Children

Letters to the editor regarding the article Dengue Fever Diagnosis, Risk Stratification, and Treatment by Paul Witte, Stefan Venturini, Helene Meyer, Andreas Zeller, and Michael Christ in issue 23/2024

Witte et al. provided a clear overview of dengue fever (1). I wish to raise some additional issues, however, that are relevant in pediatric infections with the Dengue virus. To date, few cases of children with Kawasaki syndrome who had been infected with dengue at an earlier date have been reported in the literature. The reports are mostly single-case reports from Thailand, India, and Brazil (2, 3, 4). These reports do not include any indication of the role of the microfilariae transmitted by the mosquito bite (Dirofilaria immitis, heartworm), which multiply in the right atrium and the ventricle and migrate into the right pulmonary artery. I suspect that there is a multitude of undetected and unpublished cases in which an infection with the dengue virus was the precursor of Kawasaki disease in children.

DOI: 10.3238/arztebl.m2025.0023

Dr. med. Stefan Bittmann M.A.

Pediatrician, Gronau, Germany

Visiting Professor, Shangluo Vocational and Technical College,
Shangluo, China

Conflict of interest statement

The author declares that no conflict of interest exists.

References

1. Witte P, Venturini S, Meyer H, Zeller A, Christ M: Dengue fever—diagnosis, risk stratification, and treatment. Dtsch Arztebl Int 2024; 121: 773–8

2. Mahajan A, Yadav S, Maheshwari A,et al.: Profile of children with Kawasaki disease associated with tropical infections. Indian J Pediatr 2022; 89: 759–64

3. Agarwal E, Shah D, Gupta P: Dengue fever triggering Kawasaki disease. Indian Pediatr 2017; 54: 51–2

4. Singh S, Jat KR, Suri D, Ratho RK: Dengue fever and Kawasaki disease: A clinical dilemma. Rheumatol Int 2009; 29: 717–9