Publication:

Clinical spectrum, complications and management outcomes in paediatric dengue: a retrospective analysis

Background The dengue fever remains a major cause of acute febrile illness among children in India. To provide region-specific data from central Maharashtra, this study evaluated the clinical spectrum, complications, outcomes and impact of steroid therapy in paediatric dengue patients.

Methods This retrospective observational study was conducted at a tertiary care centre in Chhatrapati Sambhajinagar, Maharashtra covering the period of January 2021 to December 2025. A total of 355 children (<18 years) with serologically confirmed dengue (NS1/IgM positive) were included. Patients were classified into mild, moderate and severe dengue according to WHO guidelines. Clinical features, laboratory parameters, steroid use in context of complications, duration of hospital stay and outcomes were analysed.

Results A total of 355 patients, 60.3% were males, with 49.0% aged 10–15 years. Mild dengue was seen in 55.8%, moderate in 38.6% and severe in 5.6% of cases. Fever was the most common symptom (98.03%), followed by abdominal pain (20.85%). Warning signs included fluid accumulation (10.70%) and mucocutaneous bleeding (9.57%). Severe manifestations such as shock (3.09%), ARDS (1.97%) and altered sensorium (1.69%) were uncommon. No cases of renal failure or major haemorrhage were observed in this cohort. Hospital stays increased with disease severity. Outcomes were favourable, with minimal mortality.

Conclusions Paediatric dengue in this cohort was predominantly mild to moderate with low complication rates. Early diagnosis and standardized, WHO-guideline-based management contributed to favourable outcomes. The judicious use of steroids in moderate and severe cases appeared to reduce complications and improve outcomes, though its effect on hospital stay remains unclear. Thus, larger prospective studies are needed to confirm the role and timing of steroids in early dengue management.