Severe asthma and dengue fever in a critically ill patient. Case report from the Intensive Care Unit.

Coaguila – Cusicanqui L.A.; Elízabeth Zeña Muñoz M.; Daniela Rodas Iberico M.; Aguilar-Gamboa F.R. · Gaceta Medica Boliviana (2025) · DOI: 10.47993/gmb.v48i1.922

Resumen

This case study presents the clinical management of a 17-year-old patient with multiple comorbidities, including dengue with warning signs, community-acquired pneumonia, respiratory failure, and a history of severe asthma. The case occurred in early 2024, in the context of a significant dengue outbreak that has affected Peru since 2023. The patient, from Chiclayo, was admitted to the Intensive Care Unit (ICU) of the Regional Hospital of Lambayeque with respiratory failure. Serological tests confirmed a dengue reinfection, raising the possibility of Antibody-Dependent Enhancement (ADE) phenomenon. The chest CT scan revealed the presence of ground-glass opacities in the lung lobes, findings compatible with viral pneumonia. During her stay in the ICU, comprehensive monitoring of the respiratory and hepatic functions was implemented, providing oxygenation support and observing a progressive decrease followed by recovery of platelets. The patient had significant respiratory compromise, requiring non-invasive mechanical ventilation and subsequently, high-flow supplemental oxygen. Clinical management included symptomatic treatment and constant hemodynamic monitoring. This case illustrates the complexity of managing patients with multiple comorbidities associated with dengue infection. It highlights the importance of a comprehensive approach in diagnosis and treatment, as well as the need to consider possible respiratory complications associated with viral diseases like dengue, especially in patients with a history of respiratory conditions such as severe asthma.

Instituciones: Universidad de San Martín de Porres; Universidad Señor de Sipán