Diabetic ketoacidosis (DKA), a common presentation of type 1 diabetes mellitus (T1DM), can be precipitated by various bacterial and viral infections. Dengue infection is an important entity that can act as a precipitating factor for DKA. The clinical presentation of DKA with dengue hemorrhagic fever (DHF) is known in adults, while it is very rarely observed in children.

A case report describes a pediatric patient who was previously healthy and subsequently, developed polyuria (above 3 ml/kg/hour), irritability and hyperglycemia (724 mg/dl) during the critical phase of DHF. 

He was rendered a diagnosis of DKA with DHF and combined national and international guidelines for the management of DKA and DHF was followed. He was administered isotonic fluids and dextran 40 to restore the hypovolaemia. 

The patient recovered without complications and was discharged home with the follow-up being advised at the endocrinology clinic.

Thus the patients with DHF and DKA together need meticulous monitoring of glycaemic control and fluid management to reduce the potential risk for severe complications of both conditions. This report remains unique as it describes DKA with DHF in a pediatric patient, which might inspire pediatricians to anticipate the possibility of DKA in children with DHF.

Source: Thadchanamoorthy V, Dayasiri K. A case report of dengue hemorrhagic fever complicated with diabetic ketoacidosis in a child: challenges in clinical management. BMC Pediatr. 2020;20(1):403. Published 2020 Aug 26. doi:10.1186/s12887-020-02300-9