Publication:

Evaluation of plasma leakage and its clinical spectrum in pediatric dengue patients in a tertiary care hospital of Bangladesh

Background Dengue is a major public health problem in Bangladesh and plasma leakage is the hallmark of severe disease in children. Early recognition is essential for timely intervention. To evaluate the prevalence, clinical spectrum and associated factors of plasma leakage among pediatric dengue patients admitted to a tertiary care hospital in Bangladesh.

Methods This retrospective observational study included 130 children aged ≤17 years with NS1-confirmed dengue admitted to the Department of Pediatrics, Delta Medical College and Hospital, from Jun-2025 to May-2026. Children referred after intravenous fluid replacement elsewhere or presenting with multi-organ failure were excluded. Hospital records were analyzed using SPSS, applying the chi-square and independent-samples t-tests.

Results Among 130 children, 65.4% were male and 35.2% were aged 10–17 years. Plasma leakage (pleural effusion and/or ascites) was identified in 6.9% of patients and abnormal ultrasonographic findings in 10.8%. According to WHO classification, 64.6% had dengue without warning signs, 24.2% had dengue with warning signs and 11.1% had severe dengue. Persistent vomiting was the only clinical feature significantly associated with plasma leakage (21.4% vs. 5.2%, χ²=5.123, p=0.024). Hemoglobin and hematocrit were higher in children with plasma leakage, but the differences were not statistically significant.

Conclusions Plasma leakage occurred in a small proportion of hospitalized pediatric dengue patients, with persistent vomiting the only clinical feature significantly associated with it. Careful monitoring of warning signs and early ultrasonographic assessment may facilitate prompt detection of plasma leakage.